[Ophthalmic pathology in tubalars of the Altai Republic].

PURPOSE: To study the prevalence and structure of ophthalmic pathology in Tubalars, rural indigenes of the Altai Republic, for the benefit of the eye care system. MATERIAL AND METHODS: A total of 673 indigenes (67% of the whole population) aged from 1 month to 88 years, 521 Russians and 316 people of mixed parentage were examined. RESULTS: The general prevalence of eye diseases appeared to be higher in Russian newcomers (2481.75 per thousand) than in Tubalars (1965.82 per thousand), while the lowest proportion was found in the group of mixed parentage (1319.62 per thousand). The structure of ophthalmic pathology in Tubalars was as follows: refractive errors and accommodative disorders (799.40 per thousand), diseases of the conjunctiva (390.79 per thousand), retinal diseases (212.48 per thousand), lens diseases (164.93 per thousand), other ocular pathology and tumors of the auxiliary structures (124.81 per thousand), disorders of the lacrimal system (112.93 per thousand), corneal diseases (87.67 per thousand), strabismus (20.80 per thousand), congenital ocular anomalies (10.40 per thousand), glaucoma (8.91 per thousand), diseases of the vascular tract (8.91 per thousand), and eye injury (2.97 per thousand). CONCLUSION: The prevalence of eye diseases in the three ethnic groups proves interethnic differences. Tubalars demonstrated intermediate results between Russians (higher rates) and the group of mixed parentage (lower rates), which indicates unequal adaptation of these populations to harsh climatic conditions of the area. The obtained data are fundamental for informed management decision-making on rational distribution of health institutions and allocation of medical personnel and funds among the regions of the country.

[Regarding the method of the total tear production assessment].

Different Schirmer test I techniques presented in the literature have been reviewed and a comparative study of Schirmer test I results obtained with the eyes opened and closed has been conducted. The total tear production with the eyes opened vs. closed averaged 17.1+/-1.1 mm and 12-1.2 correspondingly (p=0.001; Mann-Whitney U test). In 22% of patients values were higher with the eyes closed rather than opened. The authors recommend to specify the conditions of the performed test when entering the results into the patient's chart.

[Study on causes of ophthalmologists' inertia in glaucoma treatment].

The problem of inertia in ophthalmological practice, which implies the absence of any adjustment of the given treatment, even if an adjustment is objectively necessary or clinically indicated, was studied. According to the authors, the problem is most pressing when multifactorial diseases, including primary glaucoma, are concerned. An anonymous survey of 147 ophthalmologists from different West Siberian regions (Altai Krai, Kemerovo region, and Republic of Khakassia) was conducted. The set of causes for ophthalmologists' inertia was identified. The leading cause appeared to be psychological reluctance to achieve target intraocular pressure and overestimation of therapeutic success. Other causes, although less significant, include lack of professional awareness and economic barriers to decision making.

[Population-based study of tear production in healthy individuals and patients with dry eye syndrome in Altai Republic].

For the first time population-based study of tear production was performed, prevalence and risk factors of dry eye syndrome (DES) were determined in native ethnic group of Altai Republic--tubalars. Authors examined 673 people, representing 44% of the whole tubalar population. The mean total tear production (Shirmer test I) was 13,3 +/- 0,3 mm in healthy (without DES signs) tubalars. It ranges in 22,6% of healthy tubalars from 0 to 5 mm, in 20,8%--6 to 11 mm, in 20,5%--12 to 17 mm, in 34,5%-- > 17 mm. Prevalence of DES in tubalar population is 86,18 per thousand. Total tear production (Shirmer test I) in tubalars with DES ranges from 0 to 5 mm in 34%, 6-11 mm in 31,5%, 12-17 mm in 21% and > 17 mm in 13% of eyes. This results showed Shirmer test I to be nonspecific in diagnosis of DES. In author's opinion this test may be useful for follow-up and for assessment of treatment efficacy.