Purpose — to evaluate the functional results of bandage therapeutic-optical keratoplasty (BTOK) in keratoconus eyes after implantation of intrastromal corneal ring segments (CRS). Material and methods. The study included 18 patients with stage II and III keratoconus (as per Amsler-Krumeich classification) who had underwent implantation of CRS with unsatisfactory long-term outcomes. The patients were divided into two groups. The first group consisted of 7 patients (7 eyes) of 27 ± 3 years old with had past history of CRS implantation followed by the absence of predicted improvement of visual acuity during the observation period of up to 18 months. The second group included 11 patients (11 eyes) who had visual acuity improvements after CRS implantation, but had regression in the long-term follow-up of 2 to 5 years. The surgical algorithm consisted of two steps: first, all 18 patients had the intrastromal ring segments removed; second, 3 months later they underwent BTOK. Outcomes. After the removal of CRS, patients of both groups showed improvements in central corneal refraction, their visual acuity decreased to 0.07 ± 0.02 and 0.09 ± 0.04, respectively. The 36 months follow-up after BTOK revealed significant improvements in visual acuity — up to 0.48 ± 0.04 and 0.54 ± 0.11, respectively — in all patients in both group due to marked flattening of the cornea in the optical zone. Conclusion. Bandage therapeutic-optical keratoplasty allows treatment of patients with complicated or who had unsatisfactory results after implantation of intrastromal ring segments. The surgery leads to stabilization of keratectasia in keratoconus patients and significantly increases uncorrected visual acuity.

Aim. Analysis of the results of surgical treatment in patients with epibulbar malformations. Patients and Methods. The study included 126 patients with a preliminary diagnosis of “epibulbar neoplasm”, who received treatment from January 2013 to December 2017. Male patients were 57.9 % (n = 73), female — 42.1 % (n = 53). The age range was from 6 months to 82 years (13.0 ± 11.4). All patients underwent complex ophthalmological examination and surgical treatment with histological verification of the obtained material. In case of deficiency of own tissues, when the conjunctival defect was closed, plastic was made using an amniotic membrane. Results. 67 (53.2 %) patients had a diagnosis of dermoid of the conjunctiva and / or cornea. In 14.3 % of cases, a diagnosis of lipodermoid with spreading into the eyelids fornix was established. In 7 patients there was a combined lesion, of them in 4 cases with Goldenhar syndrome, 1 case with Jadassohn syndrome and in 2 cases without syndromic disorders. In 10 patients, multicentric lesions were noted with the formation of several dermoids. Choristomas of different structures were identified in 41 patients (32.5 %). Complications of surgical treatment included limitation of eye mobility (n = 9), ptosis of the upper eyelid (n = 7), diplopia (n = 4), ocular deformity (n = 3), corneal perforation (n = 1), symblepharon (n = 1) and entropion (n = 1), which required additional surgical interventions with a favorable functional outcome. Conclusions. Diagnosis of epibulbar malformations requires a comprehensive ophthalmological examination to determine the prevalence of the process, the extent of the lesion in order to plan the timing and tactics of surgical treatment. Congenital epibulbar malformations of the eye are subject to surgical treatment with the growth of lesion, chronic inflammation, cosmetic dissatisfaction and spread to the central parts of the cornea. The use of the amniotic membrane improves normal epithelization and reduces the degree of postoperative scar deformation.

Purpose: To compare three 360°-laser retinopexy (LRP) approaches (using navigated pattern laser system, single-spot slit-lamp (SL) laser delivery and single-spot indirect-ophthalmoscope (IO) laser delivery) in regard to procedure duration, procedural pain score, technical difficulties and the ability to achieve surgical goals. Patients and Methods. Eighty-six rhegmatogenous retinal detachment patients (86 eyes) were included in this prospective randomized study. Ten patients were underwent scleral buckling procedure, 37 patients were underwent vitrectomy, 7 patients had a combined procedure, and 32 patients had silicone oil tamponade. The mean procedural time, procedural pain score (using 4-point Verbal Rating Scale), number of laser burns, and achievement of the surgical goals were compared between three groups (pattern LRP (NAVILAS laser system), 36 patients; SL-LRP, 28 patients; and IO-LRP, 22 patients). Results. In the pattern LRP group, the time needed for LRP and pain level (12.4 ± 5.4 min and 1.1 ± 0.5 scores, respectively) were statistically significantly lower, whereas the number of applied laser burns (1108.7 ± 345.5) was higher compared to those in the SL-LRP group (21.7 ± 7.6 min, 1.8 ± 0.5 scores, and 714.5 ± 219.8 burns) and in the IO-LRP group (17.0 ± 10.1 min, 1.9 ± 0.5 scores, and 408.1 ± 95.5 burns). In the pattern LRP, SL-LRP, and IO-LRP groups, surgical goals were fully achieved in 28 (77.8 %), 17 (60.7 %), and 13 patients (59.1 %), respectively (p > 0.05). In the pattern LRP, SL-LRP and IO-LRP groups, the mean duration of follow-up after silicone oil removal was 6.6 ± 3.1 months, 8.1 ± 4.5 months and 7.1 ± 4.1 months, respectively (ANOVA3x, p = 0.35), with re-detachment found in 1 case (8.3 %), 2 cases (18.2 %), and 1 case (11.1 %), respectively. Conclusions. The navigated pattern approach allows improving the treatment time and pain in postoperative 360° LRP. Moreover, 360° pattern LRP is at least as effective in achieving the surgical goal as the conventional (slit-lamp or indirect ophthalmoscope) approaches with a single-spot laser.

Aim: to analyze the data obtained from using of intraocular lenses — the hydrophobic IOL Citrin and a hydrophilic IOL Aquamarine, produced by Russian company — NanOptic. Materials and methods. A total of 56 IOLs, produced by NanOptic (38 hydrophobic IOLs Citrine and 18 hydrophilic IOLs Aquamarine) were implanted. The observation period was from 3 to 12 months. The indication for phacoemulsification was age cataract. The age of the patients was 54–85. Patients before the operation were conducted basic studies. The mean uncorrected visual acuity before the operation was (UCVA) 0.121 ± 0.120 (0.001–0.3), and the mean corrected visual acuity was (BCVA) 0.187 ± 0.140 (0.001–0.6). All patients underwent standard phacoemulsification. Results. The early postoperative period was without any complications. In the postoperative period the mean UCVA in patients with “Citrine” and “Aquamarine” was 0.90 ± 0.10 (0.7–1.0) and 0.96 ± 0.07 (0.8–1.0) accordingly, and the mean BCVA was 0.94 ± 0.07 (0.8–1.0) and 0.99 ± 0.02 (0.9–1.0) accordingly. In all cases, the refraction obtained was consistent with the prediction. The error in IOL calculation was minimal and permissible. There weren’t any case of secondary cataract in patients with hydrophobic IOLs, and 3 cases of lens posterior capsule fibrosis of 1 degree in patients with hydrophilic IOLs in 3–12 months observation. The position of IOL in capsule bag was stable. Conclusions. The results of implantation of new Russian-made IOLs on the given parameters appeared to be satisfactory, that allows to recommend them for implantation in cataract surgery.

Purpose: to assess the structure of the avascular zone and Vessel Density Retina in fovea using optical coherence tomography with angiography (OCT-angiography) after surgical treatment of macular hole, (MН) with platelet-rich plasma (PRP). Patients and methods. We examined and operated 32 patients (32 eyes) with macular hole. During surgery, after posterior hyaloid and internal limiting membrane (ILM) removing the platelet–rich plazma was appliqué on the region of the hole. Оphthalmologic diagnosis and OCT angiography were performed before and in 1 and 3 months after surgery, evaluate the area of the avascular zone and Vessel Density Retina in fovea. We compared this information with a healthy eye. Results and discussion. Аll patients had significantly visual acuity increasement. Anatomical closure was confirmed in all cases. Аfter surgery, we note a decreasement in the size of the avascular zone and increasement of the Vessel Density Retina in fovea. Conclusions. OCT angiography allows to evaluate the decreasement in the size of avascular areas and increasement of the Vessel Density Retina in fovea in postoperative period.

Purpose: to study the effect of low-intensity fractal light stimulation on the sensitivity in the visual field in patients with suspected glaucoma (SG) and primary open-angle glaucoma (POAG). Material and Methods. The study involved 146 people, including 98 patients of the main group (No. 1) and 49 people from the control group “placebo”-therapy (No. 2). Standard automatic perimetry was performed (SITA-Standard, Humphrey, CarlZeissMeditec, 24-2). The dynamics of the perimetry indices MD and PSD were evaluated before and after the course of a ten 10-minute session of fractal phototherapy or after a 10-day course of relaxation consisting in watching a particular training video twice a day. The maximum brightness of the flashes on the cornea during phototherapy was 10–12 lux, the fractal dimension of the optical signal was D = 1.4. Results. A two-week course of low-intensity stimulation with fractal optical signals reliably improved the MD reflected the common defect in the visual field, in all patients with SG and POAG. The expositions to videos with a relaxation program did not have a statistically significant effect on MD and PSD indices. The pronounced effect of fractal stimulation revealed in eyes with POAG III (a reduction of MD on average by 4.39 dB) suggests that even in advanced stages of glaucoma in the general population of retinal ganglion cells there is a significant percentage of cells that are still at the plastic stage of reversible functional changes and can respond positively to therapy. The results substantiate the feasibility of application neuroprotective therapy to patients with any stage of glaucoma, including the advanced stage. Conclusion. In this study, we first used the technology of fractal optical stimulation for the treatment of glaucoma. The first evidence of the neuroprotective effect of fractal phototherapy for POAG at different stages has been obtained. Fractal stimulation can be considered as a new non-pharmacological (physiotherapeutic) approach to neuroprotective therapy, whose potential and mechanisms need to be studied in future studies.

Purpose: to study the features of the blood filling of the eye in patients with primary untreated hypothyroidism and primary untreated thyrotoxicosis by plethysmography. Materials and methods. The material of the study was the results of a comprehensive examination of 43 patients (86 eyes): 23 people (46 eyes) with primary untreated hypothyroidism and 20 people (40 eyes) with primary untreated hyperthyroidism. The ocular blood flow was assessed by ophthalmoplethysmography. Results. The obtained plethysmography data confirm that even in the absence of endocrine ophthalmopathy in patients with primary untreated hypothyroidism and primary untreated thyrotoxicosis, deep hemodynamic disturbances in the major vessels of the eye develop leading to ischemia of its anterior and posterior parts, which can lead to hydrodynamic disturbances in the eye, sensitivity of the visual analyzer to ischemia and hypoxia and to promote the development of secondary optic neuropathy. In this study, a significant reduction of 30–40 % from the norm of volume and consumption indicators of the blood filling of the eye with impaired placement of blood in the choriocapillaries, reduced elasticity of the choroidal vessel wall was detected, which can not but trigger the development of various pathological processes. For example, ischemia of the ciliary body and the trabecular meshwork, the presence of thyroid receptors on endothelial and smooth muscle cells of choroidal and orbital vessels, can lead to hydrodynamic disturbances, and ischemia of the optic nerve, which arises due to violation peripapillary flow having choroidal source of blood supply, can result in an optical neuropathy. In this aspect, thyroid disease is associated with an increased risk of developing glaucoma, endocrine ophthalmopathy. The conclusion. Despite the constant expansion of various innovative dopplerographic systems, plethysmography — as a method of examining the blood filling of the eye, remains in demand, reliable and highly informative. In patients with uncompensated thyroid dysfunctions, a violation of the blood supply to the anterior segment of the eye is observed, which can cause a low effect of antihypertensive monotherapy in the treatment of glaucoma.

Purpose: to study a correlation between morphometric parameters of the eye and tonometry data, taking into account viscoelastic properties of the cornea in patients with primary open-angle glaucoma (POAG), as well as in practically healthy individuals using different methods of tonometry. Patients and Methods. Correlations between morphometric parameters of the eye and tonometry data were studied in view of viscoelastic properties of the cornea in 51 patients with POAG who were observed at the “Optimed” Laser Vision Recovery Center in Ufa (99 eyes) and in 31 practically healthy individuals (62 eyes). Various methods of tonometry were used: tonometry according to Maklakov, contactless tonometry, tonometry with the Ocular Response Analyzer (ORA, Reichert Inc., USA), as well as ultrasound echobiometry, pachymetry. Results. The CH and CRF parameters reflecting the biomechanical properties of the corneoscleral membrane of the eye were close in value to each other with a high degree of positive correlation in the control group (ρ = 0.783, p < 0.001), with an average correlation in the group with POAG (ρ = 0.545, p < 0.001). In eyes with POAG, a negative CH correlation of average degree with corneal-compensated IOP (ρ = -0.572, p < 0.001), a negative CRF correlation of moderate degree with IOP by the Maklakov method (ρ = -0.346, p < 0.001) and corneal-compensated IOP with dynamic bi-directional applanation tonometry (ρ = -0.327, p = 0.001), low correlation with IOP using contactless tonometry (ρ = 0.243, p < 0.015) were observed. In the group of patients with POAG, a positive average correlation was found between the central thickness of the cornea and CRF (ρ = 0.398, p < 0.001), and CH (ρ = 0.368, p < 0.001), low correlation with IOP using contactless tonometry (ρ = 0.266, p = 0.008). Conclusion. Correlations of biomechanical properties of the corneoscleral membrane and morphometric parameters of the eye in patients with POAG were revealed using different methods of tonometry. In the group of patients with POAG and in the control group, positive correlations of the central thickness of the cornea with the IOP level in tonometry were determined by the contactless method, as well as with the main ORA parameters reflecting the visco-elastic properties of the fibrous membrane of the eye — the corneal resistance factor, corneal hysteresis.

Modern human life conditions are associated with the increase of visual load in the volume and intensity. It determines the social and scientific significance of the study of the visual system functional capabilities with refractive errors. Due to peculiarities such types of ametropia as hypermetropia, hypermetropic and mixed astigmatism are the cause of inadequate load on the visual analyzer. Foreign and Russian scientists mainly pay attention to the study of these functions in childhood, adolescence or presbyopic age. We studied the frequency and degree of binocular and accommodative disorders in adult patients (18–48 years) with hypermetropia, complex hypermetropic and mixed astigmatism. Depending on the type of ametropia, the patients were divided into 2 groups. Group I Hm ast included 58 patients with hypermetropia and complex hypermetropic astigmatism, group II Mixed ast — 60 patients with mixed astigmatism. Patients were divided into two subgroups depending on age: subgroup A included patients aged 18–34 years, subgroup B — patients aged 35–48 years. The control group was 50 persons with emmetropic refraction, which were also divided according to age into two subgroups. In the course of the study, there were noted violations of the accommodative, binocular, oculomotor functions in various combinations of one or several parameters in adult patients with hyperopia, complex hyperopic astigmatism, mixed astigmatism in 10–32 % of cases. A significant percentage of detected latent sensory-motor disorders determines the need for a detailed study of these functions to choose the optimal correction method.

Purpose: tо evaluate the diagnostic capabilities of optical coherence tomography (OCT), Scheimpflug camera and ultrasound biomicroscopy (UBM) in examining topography of the ocular anterior segment and lens in mature intumescent cataract. Patients and methods. 23 eyes with mature intumescent cataract were examined using OCT (RTVue-100, Optovue, USA), Scheimpflug camera (Pentacam HR, Oculus, Germany) and UBM (UD 8000, Tomey, Japan). We examined the anterior chamber depth, profile and magnitude of the anterior chamber angle, distance “trabecula-iris at 500 microns”, thickness of the liquid lenticular mass layer, lens thickness, Zinn ligament length within four segments, equatorial angle. Results. We managed to measure the anterior chamber depth using UBM and Scheimpflug camera. UBM measurement was 1.96 ± 0.14 mm, Scheimpflug camera — 1.91 ± 0.11 mm. We revealed narrowing of the anterior chamber angle up to 11.54 ± 2.19° in UMB examination, to 11.49 ± 2.17° in OCT measuring and to 11.63 ± 2.21° in examining by Scheimpflug camera. Distance “trabecula-iris 500” was 0.212 ± 0.037 mm in UMB examination, 0.218 ± 0.042 mm — by means of OCT, Scheimpflug camera measurement was unsuccessful. The rest parameters were examined only by UBM. The lens thickness was 5.26 ± 0.13 mm. The anterior layer of liquid lenticular mass was 0.85 ± 0.06 mm. Zinn ligament length in the outer segment was 0.708 ± 0.072 mm, in the internal segment — 0.731 ± 0.089 mm, in the superior segment — 0.704 ± 0.084 mm, in the inferior segment — 0.876 ± 0.089 mm. The equatorial angle in two opposite segments was 32.52 ± 0.92°. Conclusion. Ultrasound biomicroscopy has the biggest value in examining topography of the ocular anterior segment and lens in mature intumescent cataract, since only this method allows achieving the whole complex of data necessary to evaluate the swelling lens parameters. This can serve as a basis for developing the appropriate tactics of surgical intervention.

The screening method for determination of individual norm of IOP proved the efficiency for early glaucoma diagnosis and for the treatment and monitoring of a disease. Purpose: definition of compliance of IOP to individual norm or tolerant IOP (TIOP) in different age groups Patients and methods. 4212 women (65.6%) and 2205 men (34.4%) aged from 22 up to 80 years participated in a research. In total 12820 examinations were analyzed. At each patient the result of compliance of settlement TIOP to the available real oftalmotonus was estimated. Patients with excess of an oftalmotonus concerning TVGD up to 15% were carried to group with low risk of disease developing, with excess from 15 to 25% — with average risk, by more than 25% — with high risk of glaucoma development. All patients were divided into 3 groups depending on age: younger 40 years, with average age of 35 years (620 eyes); from 40 to 60 years, with middle age 54 years (2724 eyes); 60 years, with middle age are more senior 73 years. Results. The regularity consisting in decrease in an indicator of lack of risk of glaucoma with age and in increase in high risk of a disease in the senior age groups was revealed. For patients who entered into risk group, morfofunctional monitoring for the glaucoma exception, dynamic observation with the subsequent analysis of the received results through certain time was recommended. The obtained data confirm decrease in hemodynamic parameters of eyes with increase in age, and assessment of indicators of microcirculation of an eye with calculation of TIOP can be one of important diagnostic criteria for glaucoma diagnostics and monitoring.

The literature review presents information on positive effects of anthocyanins on functional indices of cardiovascular system, vascular reactivity of main arteries, microcirculation and retrobulbar blood flow. The positive effect of anthocyanins on the reactivity of main arteries was detected using non-invasive ultrasound method for assessment of flow-mediated dilation andendothelial function. Numerous randomised-controlled trials showed the effectiveness of the long-term supplementation with anthocyanins (during 6–24 months) in correction of microcirculation impairment and functional indices of visual system. The increase of plasma endothelin-1 (ET-1) level and the pathological vascular reactivity have been noted in ocular ischemic diseases such as diabetic retinopathy, occlusion of retinal veins and arteries. We registered the normalization of the plasma ET-1 level, significant improvement of blood flow in neuroretinal rim area and peripapillary area of retina without changes in mean indices of intraocular pressure and ocular perfusion pressure in patients with open-angle glaucoma after anthocyanins administration. There was no progression of visual fields defects. The resulting effect of anthocyanins supplementation consists of metabolic regulation of blood flow and flow-dependent vasodilatation due to the influence on vascular endothelium.Anthocyanins also increase the expression of endothelial nitric oxide (NO) synthase, an enzyme that generates powerful endogenous vasodilator NO. Anthocyanins regulate a number of complex immune and inflammatory signaling pathways involved in maintaining vascular functional activity. Positive dynamic of blood flow velocities and normalization of resistance indices in ocular vessels were detected in patients with dry age-related macular degeneration after 2 months anthocyanins supplementation. That indicates the improvement of ocular blood flow circulation and favorable prognosis for retinal dystrophies. The instrumental examination of blood flow in different vascular systems including microcirculation and main arteries are very useful for assessment of the effectiveness of anthocyanin supplementation.

Increased intraocular pressure (IOP) is the main risk factor for the development of primary open-angle glaucoma (POAG). Nowadays medicine that reduce IOP remain the main method of treating for POAG. The first-line drugs for POAG are prostaglandin analogues. In Russia, for the first time, it appeared not in the form of a fixed combination (Bimoptic). In this regard it is very important to evaluate the clinical efficacy and safety of Bimoptic as a monotherapy and additive component in the treatment of patients with POAG. Patients and methods. Patients were divided into 3 groups depending on the treatment. Group I comprised of 34 patients with newly diagnosed glaucoma on monotherapy with bimatoprost 0.03 %. Group II consisted of 30 patients who started taking bimatoprost 0.03 % as a replacement for latanoprost 0.005 % or travoprost 0.004 %. There were 32 patients in group III, who were prescribed bimatoprost 0.03 % as an adjuvant therapy for B-blockers (BB) 0.5 % or carbonic anhydrase inhibitors (ICA) 2 %. Results. According to the results of the clinical study, it was found that instillation of Bimoptik as a monotherapy for newly diagnosed POAG leads to a decrease in IOP level by an average of 32.1 % of the initial level. With the additive tactics of assigning Bimoptik to the BB and / or IKA, the level of IOP goes down by 10.6 % more. If prostaglandin is changed to Bimoptik, the level of IOP decreases by 12.6 % of the prostaglandin-associated values. Also according to acquired data, Bimoptik has a low percentage of adverse reactions, slight hyperemia and discomfort were observed in 5.2 % of cases in all groups. Conclution. Bimoptik effectively reduces the level of IOP in both monotherapy and additive tactics with the least adverse reactions.

Fluoroquinilones play major role in prevention of infectious complications after cataract surgery. It is important to notice their speсtrum of antimicrobial асtivity as well their sаfety and bioаvаilаbility. In our research we aimed to study in vivo the mean time of minimal inhibitory concentration (MIC) of three different fluorquinolones in aqueous humour and role of preservative presence, as well as its concentration, in reaching MIC in aqueous humour. This was a randomized study, that included 90 patients treated with fluorquinolones by the same prescription 4 drops in 1 hour every 15 mins starting 60 minutes before planned phacoemulsification. We compared 1. Oftаquix™ (levofloxасin 0.5 %; Santen Oy, Finlаnd with 0,05 mg/ml preservative); 2. Signiсef® (levofloxасin 0.5 %; Sentiss Phаrmа Pvt. Ltd., Indiа — contains 0.1 mg/ml preservative) 3. Vigаmox® (moxifloxасin 0.5 %; Alсon Lаboratories, Inс., USА without preservative). We collected aqueous humour at the surgery beginning and measured the concentration of antimicrobial drug by method of highly effective liquid chromotogrаphy. The study showed that presence of preservative in different concentration may decrease the function of corneal epithelial barrier and change drug’s potential bioаvаilаbility. Prescription of fluorquionolones eyedrops in first few days after phacoemulsification allows to reduce the risk of endophtalmitis and avoid preservative-induced side effects in short period of use.

Purpose: to evaluate the efficacy and safety of complex therapy of allergic conjunctivitis, including 0.2 % olopatodin. Patients and methods: In 40 allergic conjunctivitis (AK) patients were performed: assessment of the intensity of itching and tearing, as well as conjunctival hyperemia and folliculosis (points); Schirmer’s test (SHT; mm); tear film break up time (TFBUT, s); assessment of the lid wiper epitheliopathy symptom (LWES, points); calculation of the xerosis indicator (XI; points, according to Bijsterveld). In the 1 group (20 pollen AK patients) were given: 0.2 % olopatadine instillations (1 time per day); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 7 days of therapy). Control points: 7 and 30 days of therapy. Patients of 2 group with pollen AK and chronic blepharitis (saprophytic flora and Demodex) were performed: 0.2 % olopatadine instillations (1 time per day); eyelid hygiene (poloxamer 188 and PEG-90 gel; 2 times per day); ointment containing gentamicin and dexamethasone (application on the eyelids margins, 2 times a day, 14 days); acaricidal gel (based on preparations of sulfur, sodium hyaluronate and aloe extract; 2 times a day, from 15 days of therapy); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 15 days of therapy). Control points: 14 and 30 days of treatment. Statistical analysis included: calculation of an average and its standard deviation (М ± s); evaluation of reliability of differences in control points (Wilcoxon’s T-criterion; χ2 criterion). Statistically significant was p < 0,05. Results: Patients of both groups had good tolerability of the treatment; no significant systemic and local side effects of treatment were noted. In 1 group patients by the 7th and 30th day of therapy, a significant decrease in the severity of itching, tearing and conjunctival hyperemia was observed. By the 30th day of observation, the complete absence of itching was noted in 85 % of individuals, the absence of hyperemia — in 80 %. The rest of the observed severity of these signs did not exceed the level of one point, and their manifestations were non-permanent. Conjunctival follicular response significantly decreased by 30 days of observation. SHT showed a significant decrease in all control points, remaining within normal limits. Dynamics of TFBUT and XI by 7 days of therapy was unreliable. By the 30th day of treatment, there was a significant positive dynamics of TFBUT and XI, compared with the state before the therapy and 7 days of observation. At the same time, TFBUT and XI have reached values close to normal. In 2 group patients by the 14th and 30th day of therapy, a significant decrease in the severity of itching, tearing, hyperemia and follicular conjunctival reaction was recorded (by 1–2 points). The value of SHT showed a significant decrease in all control points (within the normal values of the indicator). By the 14th day of therapy, a significant decrease of LWES was noted; the NT and XI the dynamics were statistically insignificant. By the 30th day of observation, significant positive dynamics of NT, XI, and LWES were noted, compared with the state before the start of treatment and 14 days of therapy. Despite the almost complete relief of symptoms and signs of allergy and ocular surface condition improvement, by 30 days of observation, the magnitudes of NT, XI and LWES still did not reach the normal state, which determined the need for further artificial tear therapy, eyelid hygiene and acaricide treatment. Conclusion: Combined therapy, including 0.2 % olopatadin instillation, demonstrated high efficacy in relieving symptoms (itching, tearing) and signs (hyperemia and follicular conjunctival reaction) of allergic conjunctivitis, as well as a good safety profile.

The environmental factors influence, quite often, negatively affects the state of health. Many of them, such as smoking, deterioration in ecology, uncontrolled alcohol intake, are in detail studied in terms of harm to a human body. Nevertheless, new technologies which action is insufficiently studied, are actively introduced into modern life. So, the use of cosmetology procedures can be a striking example. Now the prevalence of such procedures as eyelash extension, a permanent make-up a century, botulotoxin injections in a periorbital zone, assumes a wide scale. In foreign and domestic literature there are more and more messages about development of the complications which arose owing to use of the above-stated procedures. There are two clinical examples from our practice in this article. They demonstrate the complications which arose after holding a procedure of eyelash extension — acute toxic-allergic conjunctivitis and after a permanent make-up — a chemical burn of a cornea. In these clinical cases of a complication arose due to aggressive action of a chemical basis of the glue applied at eyelash extension and cream-anesthetic which is applied on eyelids before a permanent make-up a century. Treatment of patients included antiinflammatory, antihistaminic, antibacterial therapy and also a long course of the tear replacement therapy applied as keratoproteсtive therapy and for prevention of development of a dry eye syndrome. Considering scales of prevalence of cosmetology procedures in recent years, it is necessary to inform specialists and patients on potential risk of development of the complications connected with the above-stated procedures. The clinical examples given in the article and literature data, demonstrate that in case of cosmetology procedures complications it is necessary to carry out timely rendering the qualified medical ophthalmologic care. It is connected with the fact that, quite often, the cosmetology manipulations, even positioned as harmless, in particular, a permanent make-up of eyelid and eyelash extension can lead to heavy complications, up to vision loss.

Open eye injury (OTG), in the structure of eye damage is up to 35.0–85.0 %, the level of disability among the working part of the male population from 26 to 55 years ranges from 25.0–47.5 %, and the removal of the eyeball due to traumatic pathology is 6.5–26.3 % of cases. The aim of the work is to demonstrate the consequences of undiagnosed cases of open injury, successfully treated in the Department of traumatology and reconstructive surgery. Attention is focused on some diagnostic techniques that contribute to the correct diagnosis, especially in undiagnosed and unoperated timely sub — conjunctival sclera ruptures that occur in 1.0–2.6 % of cases of OTG. This pathology leads to the development of severe complications with a persistent decrease in visual functions, detachment of the inner shells, with the formation of staphylomatous, cystic changes, as a rule, along the upper limb in 0.5–1.0 mm from it. There are 3 clinical cases with the description of surgical restoration of the integrity of the scleral capsule in combination with intraocular surgery, which led to good anatomical, cosmetic and functional results. In the first case, the patient with the consequence of injury with wooden shavings 6 months ago was performed a delayed revision of vascular staphyloma after separation of the conjunctiva and plastic defect sclera cadaver scleral flap. Visual acuity of OD increased from 0.4 to 0.8. The second case is the consequences of an open eye injury, dislocation of the lens under the conjunctiva. The patient underwent a delayed revision of the scleral wound with removal of the lens, microinvasive vitrectomy with removal of hemophthalmos, iris plasty and secondary IOL implantation. Visual acuity improved with pr.l.certae up to 0.7. The third case is a patient with the consequences of open trauma, staphyloma vascular, complete coloboma of the iris, traumatic cataract. Were facoaspiration traumatic cataract with IOL implantation and plasticity of the iris, delayed revision of the scleral wound plasty of the defect cadaverous sclera. Visual acuity improved with pr.l.certae to 0.2 n/K. Conclusion. Thus, thanks to the use of clinical and diagnostic methods of research and high-tech surgical technique of treatment, it was possible to achieve optimal anatomical, cosmetic results in patients with long-term consequences of complicated open eye injury. Despite the severe anatomical consequences, good functional results were obtained in all cases. In our opinion, this can be explained by the absence of damage to the choroid during the injury, which, according to the literature, mainly leads to massive bleeding into the inner shells and cavities of the eye, the development of ischemia and is the trigger for the development of vitreoretinal proliferation.

Purpose: To describe the interesting and fairly rare due to its features clinical case of secondary glaucoma caused by prolonged use of corticosteroids in the composition of ocular drops and ointments for the treatment of chronic blepharitis. Key points: The features of this case are the young age of the patient, as well as late diagnosis of steroid glaucoma and concomitant systemic disease in the form of psoriatic spondylitis, despite regular examinations of the patient by ophthalmologists from various medical institutions over the past two years in connection with the treatment of chronic blepharitis with frequent exacerbations in both eyes. The abolition of corticosteroid drugs, complex treatment in combination with immunocorrection, systemic therapy of psoriatic spondylitis and surgical treatment of glaucoma in both eyes led to long-term remission of chronic blepharitis, stabilization of the glaucomatous process and improvement of the patient’s quality of life. Conclusion: Ophthalmologists should monitor the level of intraocular pressure in all patients who are treated with drugs containing corticosteroids

Purpose: to conduct an analysis of the needs for social rehabilitation services and technical means of rehabilitation for visually impaired people in St. Petersburg. Materials and methods. A medical-sociological study was carried out on a specially developed questionnaire, which makes it possible to analyze the needs of the visually impaired in socio-rehabilitation activities and technical means of rehabilitation. Also, the official state statistical reporting data were used: «forms 7-sobes» for 2015–2016. The study included 250 people. at the age of 18–80 years, who had a disability in sight. Results. The overwhelming majority of visually impaired people (98.4 %) have disabilities of groups I and II. The proportion of disabled people in group II is the highest and amounts to 62.2 %, the proportion of disabled people in group III is the lowest — 1.6 %. Among the total number of employees, the greatest share was occupied by the disabled of the I group (41.7 %), more than half of whom (54.9 %) had no professional education. The majority of visually impaired people (62.8 %) preferred to receive social and rehabilitation services in a center specialized in the Center for Medical and Social Rehabilitation of the Visually Impaired in St. Petersburg. The need for sanatorium treatment for disabled people was significant — 73.2 %, but it was satisfied in 7.2 %. It is established that the real needs of the visually impaired in various types of technical means of rehabilitation are much greater than those suggested in the «Federal List of Rehabilitation Measures, Technical Remedies and Services Provided to the Disabled». In St. Petersburg, about 50.0 % of the visually impaired need high-tech rehabilitation equipment, for example, in a mobile phone, computer or laptop, etc. But due to their absence in the federal and regional lists, they are forced to purchase at their own expense. The conclusion. It is advisable to provide social and rehabilitation services for visually impaired people on the basis of specialized centers (departments) that have a more diverse set of services for the most complete satisfaction of their needs. The needs for sanatorium treatment are minimally satisfied, which makes it necessary to improve the system of organization of sanatorium-and-spa treatment. For the visually impaired, the need for technical means of rehabilitation is satisfied at 75.0 %, which is the basis for considering the issue of expanding the range of the Federal List.

The article presents scientific views on the myopia of one of the founders of the national school of ophthalmology — Professor E.V. Adamjuk (1839–1906). Exactly 150 years ago, in his work “About Short-sightedness” (1874), the scientist gave a detailed description of this refractive error, outlining the main reasons for its development. To these reasons, he attributed a long-term work at the closest distance, stretching the posterior segment of the eyeball with the formation of a myopic crescent and staphyloma, which he found in his patients using an ophthalmoscopy. In another publication, devoted to the analysis of the article of the hygienist V.V. Erisman, “The Impact of Schools on the Origin of Myopia on Observations on Students in Educational Institutions of St. Petersburg” (1871), the professor identified poor illumination and poor posture among schoolchildren as the main factors in the formation of myopic refraction. Many postulates advanced by E.V. Adamjuk in the XIX century, influenced in the views of modern ophthalmologists on the etiopathogenesis and prevention of myopia.