[Ocular surface viral diseases in children]. / Virusnye zabolevaniya glaznoi poverkhnosti u detei.

UNLABELLED: Over the past 15 years the number of children with inflammatory eye diseases has increased by five-six times. Data analysis of Moscow children's health clinics in 2014 showed that for 40,000 outpatients a viral infection was observed in 49,000 cases, whereas some children suffered from the viral infection twice or thrice. 344 children (0.7 percent) had the viral infection accompanied by keratoconjunctivitis. According to 2015 data, viral infection was observed in 37,957 children, including 325 outpatients (0.8 percent) with keratoconjunctivitis. AIM: To analyze clinical features and treatment options of ocular surface viral diseases in children. MATERIAL AND METHODS: We observed 140 children aged 2 to 13 years with ocular surface viral diseases. RESULTS: Despite the presence of corneal disorders, in 95 percent of children changes were reversible - in 1.5 months corneal opacity was not observed. Yet five percent of children, despite the intensive treatment, had bacterial complications, causing decrease in visual acuity. CONCLUSION: In case of viral infections, ophthalmologists, pediatricians and general practitioners should all be aware of ocular manifestations of these diseases. Even if adequate therapy for ocular surface viral disorders is appointed, in five percent of cases complications are possible, causing decline in visual function. Changes in vision can be a result of general disease manifestation, and only timely and proper treatment will help to relieve the symptoms of inflammation and prevent complications.The results of our observations revealed that the addition of Ophtalmoferon medication to the complex therapy of ocular surface diseases in children showed a high therapeutic efficacy and a good safety profile. This medication, in contrast to other antiviral agents, is available in the form of ready-to-use eye drops, significantly enhancing medication compliance in outpatients.

[Efficacy of lid hygiene in treatment of patients with blepharoconjunctival form of dry eye syndrome].

A complex of measures for lid hygiene in ocular surface disease is developed. These measures together with tear substitution and antibacterial treatment were revealed to result in elimination of blepharoconjunctivitis and dry eye signs, recovery of tear film and long-time remission, that significantly improved patient's life quality. When using this complex of measures meibomian glands are not damaged and their anatomy and functions are completely preserved. Lid hygiene affects all glands, there is no pain and no local anesthesia needed, normal tear film is formed

[Clinical features of the blepharoconjunctivitis type of the dry eye in demodicosis].

The paper presents data on demodicosis-induced blepharoconjunctivitis complicated by the dry eye, such as predictors, etiology, and pathogenesis of this disease. It gives a concise outline of the life history of mites and their species parasitizing on the human skin cycle and an extended treatment regimen for blepharoconjunctivitis complicated by the dry eye. The time course of changes in the pathological signs of blepharitis is shown when the latter is treated using the given regimen and the treatment is discontinued. The authors provide the data of Schirmer's test and Norn's test, which have been used to support the results of the present investigation. The mechanism of action of the drugs considered in the paper on the eyelids is outlined. There is a tendency for demodicosis-induced blepharoconjunctivitis to be completely eliminated and the signs of the dry eye to be compensated when meticulously chosen therapy, including hygienic measures, is performed.

[The features of the clinical course of different forms of the dry eye syndrome are the basis for development of adequate treatment modalities].

The paper presents two classifications of the dry eye syndrome: the Madrid and Russian classifications. The creation of its classification is required for the elaboration of treatment policy for this category of patients. The classifications are based on the scientific data on the epidemiology, etiology, and pathogenesis of the dry eye syndrome. Each classification identifies different forms of the dry eye. The classifications virtually published at the same time do not greatly differ from each other and they reflect the current approach to systematizing different forms of the dry eye. The paper analyzes the Madrid versus Russian classifications.

[The clinical results of using specialized laser keratomileusis for the correction of myopia]. / Klinicheskie rezul'taty primeneniia lazernogo spetsial'zirovannogo keratomileza dlia korrektsii miopii.

Laser in-situ keratomileusis has been performed on 2023 eyes of 1162 patients with myopia of 1-18 diopters and complex myopic astigmatism of 0.75-5 diopters. A Hansatome TM 230 HT keratome and Nidek EC 5000 eximer laser device were employed. The resultant refraction and visual acuity were analyzed during one year postoperation in different age groups and groups with myopia of different degree. In myopia of up to 6 diopters high visual acuity without correction (0.93-0.99) was attained in all age groups. In higher myopia, visual acuity has been increasing over the entire period of observation, the gradient of its alteration being 0.17-0.27. The final visual acuity formed in presbiopes during 3 months. The spherical refraction equivalent of up to 1 diopter was 96.1%. The mean refraction values were stable during the entire period of observation. In myopia of 9.5 diopters and higher the residual myopia in patients aged over 30 years was approximating 1.0 diopters. Hypercorrection was observed in 1.3%, hypocorrection in 2.6% cases. The described combination of equipment for laser keratomileusis provides stable visual and refraction results at a lower incidence of complications.

The corneal barrier function in myopic eyes after laser in situ keratomileusis and after photorefractive keratectomy in eyes with haze formation.

BACKGROUND: Corneal barrier function following photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) was evaluated to determine corneal damage and to compare the amount of corneal trauma associated with haze development with the two procedures. METHODS: The PRK and LASIK procedures were performed with the Nidek EC-5000 excimer laser. The Chiron Hansatome microkeratome was used in the LASIK procedures. We followed 1528 eyes of myopic patients (range, -1.00 to -23.00 D) classified into three groups according to age. Each group was divided into four subgroups depending on the amount of myopia (-1.00 to -2.75 D; -3.00 to -5.75 D; -6.00 to -9.75 D; -10.00 to -23.00 D). In eyes with haze formation, haze intensity and postoperative period of haze development were evaluated. The corneal uptake was 5.6 carbonfluorescein 5%, and a computer program analyzed video slit-lamp corneal images. RESULTS: PRK and LASIK increased corneal permeability to fluorescein (2 to 8 weeks after PRK and 4 to 6 weeks after LASIK). Deeper ablations showed higher corneal fluorescein permeability for longer periods. In eyes with haze formation, an increased index of corneal fluorescein permeability was observed in the eyes with early postoperative haze formation (1 to 2 months) and a decreased index of corneal permeability was observed in eyes with late postoperative period haze formation (after 3 months). This finding suggests a difference in the haze that developed in the early and later postoperative periods. Fluorescein permeability after PRK returned to normal in 2 to 8 weeks and remained constant. Following LASIK, fluorescein permeability returned to normal in 4 to 6 weeks. Decreasing corneal permeability to fluorescein was observed 2 to 6 months after LASIK, and returned to normal at 6 months. CONCLUSION: Photorefractive surgery disrupts corneal barrier function for up to 6 months postoperatively, even though other clinical tests of the cornea may be normal. This finding may help explain some mechanisms of pathogenesis of complication development following PRK and LASIK. The fluorescein permeability findings demonstrated different mechanisms for early and late haze formation after PRK.

[Objective indices of corneal transparency and of fluorescein permeability through the cornea before and after photorefractive keratectomy]. / Ob''ektivnye pokazateli prozrachnosti i pronitsaemosti fliuorestseina cherez rogovitsu do i posle fotorefraktsionnoi keratoéktomii.

Video images of the cornea in photorefraction keratectomy (PFK) are analyzed by computer-aided microdensitometric analysis of televideo images of the eye. Optic density of various layers of the cornea and fluorescein penetration through the cornea were assessed in patients with myopia (235 eyes) and hypermetropia (65 eyes) before the after PFK. PFK was carried out by Nidek excimer laser (Japan). Analysis was carried out with consideration for the degree of emmetropia and patients' ages. Corneal transparency and index of fluorescein penetration through the cornea correlated with patient's age and emmetropia. Computer-aided microdensitometric analysis of televideo images of the eye earlier detects changes in the cornea than routine methods. The authors discuss the probability of assessing corneal transparency for selection of patients for PFK.

Corneal transparency and measurement of corneal permeability in excimer laser photorefractive keratectomy.

PURPOSE: To introduce an image analysis of the cornea in photorefractive keratectomy (PRK) for preoperative and early postoperative determination of changes in the condition of the cornea. METHODS: Slit-lamp videography was used to evaluate the cornea. Microdensitometry of the corneal images was performed. The optic density of the anterior, middle, and posterior corneal layers was measured. Photorefractive keratectomy was performed with the Nidek EC-5000 excimer laser. We followed patients with different amounts of myopia (range, -1.00 to -20.00 D) classified into three groups, according to age. Each age group was divided into four subgroups depending on the amount of myopia. RESULTS: The analysis of the microdensitometry results of the optic section of transparent corneas in myopic patients demonstrated differences depending on age and mean amount of myopia. A correlation between the microdensitometric data of permeability by fluorescein and the refractive results of PRK was found. CONCLUSION: Quantitative image analysis of the cornea is a useful method to evaluate the condition of the cornea before and after PRK. This method can identify early damage to the cornea in myopia patients. Preoperative investigation of permeability of the cornea using fluorescein is an important method for selection of the patients for PRK.