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Purpose. To analyze changes in binocular vision functions in patients with acutely acquired esotropia after preoperative correction by prisms. Material and methods. The study included 16 patients with acutely acquired esotropia with diplopia. Depending on the tactics of preoperative case management, two groups were distinguished. Eight patients with acutely acquired esotropia of the Bielshowsky type at the age from 12 to 35 years old (mean age, M±sd – 17.5±1.9 years). This group underwent preoperative prismatic correction of diplopia and the deviation angle, as well as eight patients with acutely acquired esotropia of the Bielshowsky type at the age from 12 to 35 years (18.5±1.9 years). Patients in this group underwent surgery without prior prismatic correction. Fresnel prisms were used to select and assign prismatic correction. The patien s were monitored dynamically. Results. In the course of treatment 1 group (prismatic correction followed by surgical correction) according to the indicator of Worth’s four-dot test color test, revealed a statistically significant increase in the frequency of value of the binocular single vision (p=0.041), the frequency of the presence of stereovision according to the Fly-test (p=0.013), fusion amplitude in the distance by 1.11 times (p=0.033) and near fusion amplitude by 1.15 times (p=0.003). Significant differences between the groups were observed only in the frequency of stereovision presence according to the Fly-test after treatment, which was 2.0 times higher in group 1 (p=0.041). Conclusion. Prismatic correction in combination with surgical treatment had better curative benefits than surgery itself in improving both binocular and stereoscopic visual functions.

Purpose. Analysis the effectiveness of prismatic correction in the treatment of congenital horizontal nystagmus. Material and methods. The study included 20 patients with congenital horizontal nystagmus. Depending on the type of nystagmus and compensatory mechanisms to reduce its amplitude, two groups were identified: 10 patients with pendular nystagmus and nystagmus blockage syndrome (mean age, M±sd, 5.8±1.9 years) and 10 patients with jerky nystagmus and abnormal head posture and a null zone (5.7±2.1 years). Fresnel prisms were used to select and prescribe prismatic correction. Patients were under dynamic control from 6 months to 2 years with an assessment of the results every 3 months. Results. During treatment (using prism correction), uncorrected visual acuity had a statistically significant increase of 1.8 and 1.5 times both in the first (p=0.004) and the second (p=0.001) group, respectively. A similar, and even more pronounced, change in visual acuity was observed for corrected visual acuity – in the first group it increased 3 times (p=0.001) and in the second group 2.2 times (p=0.001). Conclusion. Prismatic correction in pendular nystagmus and esotropia allows to simulate (eliminate) nystagmus blockage syndrome and, thereby, to improve the quality of vision of the patient. In its turn, prismatic correction in jerky nystagmus with abnormal head posture allows to move null zone into the primary position of gaze, increase visual acuity due to the optimal optical correction and improve the patient’s quality of life.

Background. Primary inferior oblique muscle overaction (PIOOA) may occur for various reasons and happens to 72 % patients with infantile esotropia. The criterion for the first surgical step is prevalence of vertical or horizontal deviation. The choice of tactics weakening inferior oblique muscle is ambiguous.Aims: to carry out retrospective analysis of PIOOA frequency in patients with infantile esotropia; to assess influence of esodeviation reduction by a surgical, chemodenervational or prismatic method on the existing PIOOA dynamics; to assess clinical and functional results of PIOOA treatment.Methods and methods. The retrospective analysis of 572 patients’ cases lay in assessment of PIOOA frequency and rate in patients with infantile esotropia that manifested under 9 months, with different treatment tactics. The prospective part of the research included two groups of patients. Group 1 (106 patients, 222 eyes) – studying the influence of surgical treatment of PIOOA. Group 2 (127 patients, 207 eyes) – studying the effectiveness of surgical PIOOA treatment. Conclusion. PIOOA frequency in case of different treatment tactics for patients with infantile esotropia is from 17 to 69 %, and the degree of its clinical manifestation is from 1.2 ± 0.4 to 2.6 ± 0.8. Bilateral weakening of medial rectus muscle reduces its probability up to 17–19 %, and the degree of its manifestation up to 1.2 ± 0.4. In cases of combination of PIOOA with infantile esotropia from 20 to 25° with paretic component, it is reasonable to carry out esodeviation reduction by means of bilateral recession, chemorecession or prismatic correction as the first treatment stage, whereas the rate of existing PIOOA is credibly reduced. In cases of choice of tactics, which is necessary for clinically significant reduction or elimination of PIOOA, it is reasonable to carry out chemorecession, marginal partial myotomy or myectomy depending on the PIOOA manifestation.

The purpose of our study was to analyze the effectiveness of the use of Fresnel prisms for various disorders of the eye movement.Material and methods. The studied group included 40 patients with prismatic correction and was divided into 2 groups of patients depending on the type of strabismus: 25 patients with incomitant strabismus, 15 patients with comitant strabismus. Elastic Fresnel prisms (EFP) were chosen and prescribed for prismatic correction. The patients were under dynamic monitoring under conditions of continuous use of EFP and positional trainings were performed if necessary (when doubling wasn’t completely compensated by EFP). The study had a prospective character.Results and its discussion. The prismatic correction made it possible to eliminate diplopia in direct gaze position and peripheral gaze directions in all 25 patients with paretic strabismus. In 18 out of 20 cases, the prismatic correction allowed to achieve functional recovery without subsequent chemorecession or surgical treatment. In 8 patients with comitant strabismus after the first stage of surgical treatment with stable deviation, binocular vision was formed under natural conditions. In 1 year, dynamic prismatic correction contributed to the recovery of 7 patients without surgical treatment with orthophoria in vivo.Conclusion. Prismatic correction of diplopia as an independent or additional functional method of treatment contributes to the achievement of the comitance of the eye muscles.

Purpose – to analyze the effectiveness of the algorithm used to monitor and treat premature infants. Material and methods. 903 premature babies were under the supervision of ophthalmologists from our clinic over the past 4 years (2014–2017). Retinopathy of prematurity was revealed in 302 patients. The laser photocoagulation was required in 78 cases. Repeated interventions were performed in 13 patients. Induced regression of the disease occurred in 72 children. The development of the 4–5 stage of the active phase of retinopathy of prematurity occurred in 6 patients. In 4 cases, the development of the 4–5 stage of the active phase of retinopathy of prematurity occurred in the case of posterior aggressive retinopathy. Results and discussion. The teamwork of ophthalmologists and neonatologists, timely and complete examination, reveals early signs of retinopathy of prematurity. Timely laser photocoagulation reduces the risk of disability, development of blindness and low vision. Reducing the number of laser photocoagulation carried out with an unchanged number of examinations, a low number of patients with terminal stages of the disease testify to the high effectiveness of monitoring and treatment of children with retinopathy of prematurity.