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The paper analyzes the references given to papers in the Russian and foreign literature on the current methods of the early diagnosis and monitoring of vascular pathology of the eyeground. Their main merits and demerits are noted. Data on that adaptive optics and calibrometry may be used concurrently are given. This problem needs further investigation.

To review the literature devoted to the problem of primary anterior chamber angle closure (PAC) and the development of this pathology from glaucoma suspect to primary angle closure glaucoma. The paper includes a trend analysis of the studies concerning primary angle closure suspects (PACS). The concept of this review is conditioned by the conflicting strategies for treating patients with initial PAC without glaucomatous optic neuropathy. Solving the problem of angle closure plays a key role in preventing the development of PAC glaucoma, which is the world's leading cause of irreversible blindness. This part of the review provides information on the frequency and rate of disease progression in PACS. The analyzed literature data is contradictory and indicates the need for further search that would consider a standardized approach to defining the concept of PAC disease, demographic factors and unified examination methods for generalizing and systematizing data in order to draw out unified treatment recommendations.Обзор данных литературы, посвященной проблеме первичного закрытого угла передней камеры (ПЗУ) и развитию указанной патологии от подозрения на это состояние до образования первичной закрытоугольной глаукомы. Представлен тренд-анализ исследований, проведенных на лицах с подозрением на первичный закрытый угол (ППЗУ). Концепция обзора обусловлена противоречивыми стратегиями лечения пациентов на этапе дебюта ПЗУ, еще без формирования глаукомной оптической нейропатии. Решение проблемы закрытого угла играет ключевую роль в профилактике развития закрытоугольной глаукомы, являющейся ведущей причиной необратимой слепоты во всем мире. В настоящей части обзора приводятся сведения о частоте и сроках прогрессирования ППЗУ. Данные проанализированной литературы носят противоречивый характер, что указывает на необходимость дальнейшего поиска с учетом стандартизированного подхода к определению понятия заболевания ПЗУ, демографических факторов и унифицированных методов обследования для обобщения и систематизации данных с целью выбора единых терапевтических рекомендаций.

The paper provides a rationale and indications for diascleral removal of foreign bodies from the anterior chamber of the eyeball, by intraoperatively using ultrasound study. The clinical material presents 148 cases of diascleral removal of foreign (49 magnetic and 49 amagnetic) bodes impacted into the tunics of the anterior eye without evident opacities of optical media and without signs of endophthalmitis. The paper provides a pathogenetic rationale for the method that is lowly traumatic and highly effective (foreign bodies being removed in 99.9% of cases) due to the high precision of location of a scleral cut in the projection of foreign body bedding owing to intraoperative sound usage. A model clinical case of fragment removal is also shown in the paper. The specific features of criteria for using the method are described, by taking into account the anatomic characteristics of orbital eyeball location.

The paper provides the results of a 15-year following-up of 91 patients with exposed orbital implants made from synthetic and biological materials. Surgery was made in the patients treated at different health care facilities. The authors analyze the causes of implant exposure in different periods. Early after surgery the most common causes of implant exposure are surgical equipment failure (inadequate implant coating with adjacent tissues), a too large implant arching the tissues, and mismatch of an artificial eye. In the late period, the more common cause is secondary infection or the toxic properties ofa material itself, which cause a persistent chronic inflammatory reaction. Moreover, the authors consider the mechanism of implant exposure and rejection depending on the material of an implant. The paper describes medical and surgical treatments in patients of this group.

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 paper describes the stages of development of unique tests for strict threshold estimation of the color power of each retinal color (red, green, and blue) perception under the direction of Ye. N. Yustova. These threshold tables are shown to be more informative in the diagnosis of both congenital and acquired color visual disorders than all other existing appliances intended for either evaluation of color anomaly or detection of chromaticity (rather than color as an item of three components!). Due to their high informative value and, at the same time, easiness-to-use, and cheapness, the tables developed by Yustova et al. should be an obligatory attribute of an ophthalmologist's work place. For this, they should be reissued, by taking into account comments on the first edition, which are mentioned in the paper.

The paper describes a procedure for intraoperative diagnosis of Zinn's zonula defects in intraocular lens (IOL) implantation. Studies were made during treatment of 14 patients (14 eyes) with complicated cataract, in whom intraoperative endoscopic diagnosis of dislocation of the lens was made. The diagnosis of third-degree lenticular subluxation was verified in 9 patients; in 5 patients who were biomicroscopically diagnosed as having second-degree lenticular subluxation, its third-degree was revealed by intraoperative endoscopy. The paper provides strong evidence that the use of endoscopes in the surgery of the anterior ocular portion facilitates the diagnosis of lenticular ligamentous apparatus disturbances in the miotic rigid pupil, altered anterior segment due to injuries to the organ of vision, aids in defining the surgical treatment policy, the choice of a method for lenticular removal, and the type of an implanted IOL.

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 paper describes the methods and results of multimodality treatment for progressive myopia in children and adolescents, by applying acupuncture, massage, and manual therapy. Thirty-three patients aged 7 to 17 years who had progressive myopia of 0.5 to 10.8 diopters were treated by an original procedure as repeated courses. Their follow-up lasted 2 years. A beneficial therapeutic effect as increases in uncorrected and subcorrected visual acuity, ocular accommodation reserves, and myopia regression rates was observed in 64% of the patients. Two-year myopia stabilization was achieved in 45% of cases. There were neither complications nor side effects. The possible mechanism of the remedial effect of the procedure is discussed in the paper.

The paper deals with the analysis of the outcome of severe eye contusion in scleral ruptures that are subject to none or inadequate debridement. In 2004, a group of 85 patients undergone enucleation due to severe posttraumatic changes was examined to analyze the outcomes of misdiagnosis of ruptures of the scleral capsule of the eye in its contusions and penetrating wounds. Examination of the eyeball after its removal revealed different defects of the optic scleral capsule in 6 (8.2%) cases of the 85 patients undergone enucleation. Each case pointing to the undiagnosed pathology of the eye during primary debridement and surgical treatment of these patients or to the partial debridement of scleral wounds is noteworthy. It should be noted that a primary care involving debridement was delivered to virtually all patients in different ophthalmological facilities. The paper gives a detailed account of each case, by describing its history data, the state of the eye, the performed studies and operation, and presents photos demonstrating each case. In eye contusion, it is necessary to adequately evaluate its severity and to reveal the whole complex of injuries and also to pay attention to the quality of debridement of wounds since adequate containment of a wound of the eye and adaptation of its edges can preserve the eye as an organ in most given cases.

The paper gives the preliminary results of an analysis of the metric characteristics of images in 40 patients with the anomalous outline of the lid slit of varying genesis, by applying an original computer program. The program is based on the principle of automatically finding the line of the true symmetry of the face, its paired fixed points, and the orientation of an image. Computer-aided estimation of the shape and width of the lid slit, the parameters of the lids along the conventional lines shows that the measurements are of high accuracy (0.1 mm for linear values and 0.1 for angular values). The paper analyzes the effect of modified resection of the superior tarsal muscle. In a patient with aponeurotic ptosis, the uplift of the upper lid was 4.1 mm (1.9 mm higher than that obtained by a pharmacological test). In the author's opinion, the proposed procedure makes it possible to solve the problems associated with the processing, storage, and transmission of images and with the assessment of relationships of the structures of the appendage of the eye.

The most well-studied and widely prescribed fixed-combination drug for open-angle glaucoma is latanoprost/timolol. Its significant hypotensive effect is especially important in challenging cases, among which are patients with normal-tension glaucoma. With long life expectancy and the constant need for treatment, requirements are high for both the effectiveness of the drug and its tolerability. This paper presents a follow-up of 7 patients with normal-tension glaucoma who have been using the fixed combination of latanoprost/timolol for 10 years. All patients showed very good tolerability to the drug and their quality of life was preserved. A moderate rate of disease progression according to static perimetry was noted in one case. A mild degree of dry eye syndrome according to the OSDI questionnaire and an objective assessment of the state of the ocular surface was observed in one patient. The latanoprost/timolol fixed combination is a well-tolerated, highly effective and safe long-term treatment choice for normal-tension glaucoma.Наиболее хорошо изученной и часто назначаемой при открытоугольной глаукоме является фиксированная комбинация латанопрост/тимолол. Ее значительный гипотензивный эффект особенно важен в тех случаях, когда снижение давления представляет собой сложную задачу. Именно к таким ситуациям относится лечение пациентов с глаукомой нормального давления. Большая ожидаемая продолжительность жизни и необходимость пожизненного лечения определяют высокие требования не только к эффективности терапии, но и к переносимости препарата. В данной работе приводится наблюдение за 7 пациентами с глаукомой нормального давления, применявшими фиксированную комбинацию латанопрост/тимолол в течение 10 лет. У всех пациентов отмечены очень хорошая переносимость комбинации и сохранение качества жизни. Умеренная скорость прогрессирования заболевания по данным статической периметрии отмечена в 1 случае. У 1 пациента по результатам опросника OSDI и объективной оценки состояния глазной поверхности была выявлена легкая степень синдрома сухого глаза. Таким образом, фиксированная комбинация латанопрост/тимолол является высокоэффективным и безопасным средством для долгосрочного лечения глаукомы нормального давления, обладающим хорошей переносимостью.

The paper presents an analysis of traumas of the orbit combined with craniocerebral trauma in children made according to data obtained at the eye microsurgery department, Morozov's Pediatric City Clinical Hospital. Fractures of the lower orbit wall account for around 70% of all orbit fractures; clinical signs of fractures of the lower orbit wall are defined; computer tomography is shown to be the most informative diagnostic tool. The paper contains indications for plasty of the lower orbit wall. Materials used in orbitoplasty are comparatively analyzed. The use of demineralized osseous implants is preferential.

The World Health Organization recommends monitoring the trends and assessing the progress of ophthalmic care focused on the actual needs of people. To solve these problems, the authors of this paper have proposed and tested an analytical model, named «Cataract», which on the one hand can help evaluate the needs of the population in terms of cataract treatment, and on the other - assist with analysis of the available resources to meet these needs. The model can help identify the bottlenecks and predict the required resources, as well as assess the degree of satisfaction of the population's needs with the current and projected amount of medical care. This model allows analyzing, planning or predicting the resources of healthcare facilities needed for the treatment of cataracts while simultaneously assessing its impact in order to meet the medical needs of patients with cataracts.Всемирная организация здравоохранения рекомендует проводить мониторинг тенденций и оценку прогресса в вопросе оказания офтальмологической помощи, ориентированной на реальные потребности людей. Для решения этих задач авторами разработана и протестирована аналитическая модель «Катаракта», которая, с одной стороны, производит оценку потребностей населения в лечении катаракты, а с другой стороны — анализ наличных ресурсов для удовлетворения этих потребностей. Модель позволяет выявлять узкие места и прогнозировать необходимые ресурсы, оценивать степень удовлетворения потребности населения при текущих и прогнозных объемах медицинской помощи. С ее помощью можно анализировать, планировать или прогнозировать ресурсы медицинских организаций для лечения катаракты с одновременной оценкой последствий для удовлетворения потребностей больных с катарактой в лечении.

Posterior chamber phakic intraocular lens (PIOL) implantation is a widely accepted and performed refractive surgery for correction of moderate and high myopia used when corneal laser ablation procedures are not suitable. This paper analyzes literature data to reveal the advantages and limitations of the technology.Имплантация заднекамерных факичных интраокулярных линз является широко распространенным и часто используемым способом рефракционной хирургии, применяемым для коррекции миопии средней и высокой степени, когда невозможно проведение лазерной абляции роговицы. В представленном исследовании проанализированы преимущества и недостатки этой технологии на основании данных литературы.

The paper deals with the treatment of severe congenital upper lid ptosis. In cases with the minimal mobility of the upper lid suspending operations are usually resorted to, those with suspending to Whitnall's ligament, among other things. Maximal resection of the levator muscle brought about encouraging results. The present paper describes the results of a modified operation: maximal resection of the levator with transposition of the muscle through Whitnall's ligament. A peculiar feature of surgical technique consists in preserving the intactness of the transverse ligament of the upper lid, crossing the lateral horns of the levator through the entire height, and transposition of the resected levator above Whitnall's ligament, this followed by suturing to the tarsal plate. The results of surgery were good. A better cosmetic and functional effect was attained than after common maximal resection of the levator; moreover, a lesser resection of the levator is needed in cases with the same degree of ptosis.

The article reviews international and Russian scientific papers concerning the possibility of transmitting coronavirus infections, particularly the COVID-19, through eye surface. According to the studied literature, the incidence of ocular symptoms in COVID-19 is around 0.8-31.6%, with conjunctivitis being the most frequent manifestation. The review summarizes data on virus detection in conjunctival discharge of COVID-19 patients. Across six studies, the total number of patients is 252, among which were 8 cases (3.17%) of virus detection in the conjunctival cavity. The review discusses the reasons for infrequent detection of the virus in the lacrimal fluid. The analyzed data shows that COVID-19 associated conjunctivitis can be the first symptom, the primary manifestation, or sometimes be detected in the lacrimal fluid of patients without any concomitant signs of eye surface inflammation. The article also presents two clinical cases of patients with keratoconjunctivitis and conjunctivitis associated with COVID-19, as well as the results of experimental transconjunctival and respiratory exposure of Rhesus macaques to SARS-CoV-2 with conclusion of possibility of this type of transmission. Additionally, the review contains the opinion of researchers concerning the influence of several factors on the possibility of virus detection in the lacrimal fluid. The conclusion was made that there is possibility of COVID-19 transmission through the eye surface. While it is not being considered a major transmission route, it should not be ignored. Conjunctival cavity of COVID-19 patients can be the source of infection. Eye protection measures should be undertaken when working with potentially infected patients.Статья представляет собой обзор зарубежной и отечественной литературы, посвященной возможности передачи коронавирусной инфекции, в частности COVID-19, через поверхность глаза. В рассмотренных работах изучена частота глазных проявлений (основное из которых — конъюнктивит) при COVID-19, составляющая от 0,8 до 31,6%. В обзоре обобщены статьи, в которых представлены данные об обнаружении вируса в конъюнктивальном секрете больных COVID-19. В шести работах общее количество пациентов, включенных в исследования, составляет 252, из этого числа у 8 (3,17%) больных был обнаружен вирус в конъюнктивальной полости. В обзоре рассмотрены причины, по которым вирус редко обнаруживается в слезе. Данные литературы показывают, что конъюнктивит при COVID-19 может быть первым симптомом, может служить ведущим проявлением заболевания, а также вирус может обнаруживаться в слезе пациентов без признаков воспаления глазной поверхности. Представлены два клинических случая — наблюдения пациентов с кератоконъюнктивитом и конъюнктивитом на фоне COVID-19. Приведены результаты экспериментальной работы по заражению макак резусов вирусом SARS-CoV-2 через конъюнктиву и дыхательные пути, авторами был сделан вывод, что заражение через конъюнктиву возможно. В обзоре изложено мнение исследователей о влиянии различных факторов на вероятность появления вируса в слезе. Сделано заключение, что заражение COVID-19 через глаза возможно. Может быть, это и не основной путь передачи, но игнорировать его нельзя. Конъюнктивальная полость пациентов с COVID-19 может стать источником заражения. Необходимо использование защитных средств для глаз при работе с потенциально опасными пациентами.

The paper presents an atypical case of solar retinopathy after short-term exposure to reflected focused sunbeams. An ophthalmoscopic peculiarity was the presence of intraretinal hemorrhage. The basis for establishing the diagnosis were spectral optical coherence tomography and fluorescein angiography findings.В работе представлен атипичный клинический случай солнечной ретинопатии после кратковременного воздействия отраженного сфокусированного солнечного луча. Особенностью офтальмоскопической картины в данном случае являлось наличие интраретинального кровоизлияния. Основой для установления диагноза стали данные спектральной оптической когерентной томографии и флюоресцентной ангиографии.

The paper presents clinical and morphological case analysis of primary intraocular malignant medulloepitelioma (medulloblastoma) of rare localization (central part of the retina with optic nerve involvement) that simulated retinoblastoma in a 2-year-old child. Histological features of the tumor are given in details (tubular and mesh structures of the tumor, rosettes, ribbons, cells with hyperchromic nuclei, and cellular polymorphism). An experience of creating a primary intraocular malignant medulloepitelioma cell culture, as yet exclusive in the Russian Federation, is described. Culture sensitivity for particular drugs (oxaliplatin, irinotecan, ifosfamide, and ascorbic acid at different concentrations) was evaluated by MTT-assay. Of the four products, IC50 (3.3 mg/ml) was obtained only for ascorbic acid. Despite the relative rarity of primary intraocular malignant medulloepitelioma, its differential diagnosis should be carried out, with retinoblastoma in mind in the first place. The obtained data on the effectiveness of ascorbic acid against intraocular malignant medulloepitelioma cells can be used to supplement the existing chemotherapeutic protocols in pediatric ocular and neuro-oncology.В работе представлен клинико-морфологический анализ случая первичной внутриглазной злокачественной медуллоэпителиомы редкой локализации - центрального отдела сетчатки с вовлечением диска зрительного нерва, - симулирующей ретинобластому, у ребенка 2 лет. Подробно приведены гистологические особенности опухоли (трубчатые и сетчатые структуры опухоли, розетки, ленточные образования, клетки с гиперхромными ядрами, клеточный полиморфизм). Описан единственный на сегодняшний день в Российской Федерации опыт создания первичной культуры внутриглазной злокачественной медуллоэпителиомы с последующей оценкой чувствительности (МТТ-тест) к четырем препаратам (оксалиплатин, иринотекан, ифосфамид, аскорбиновая кислота) в различных концентрациях. Из четырех исследованных препаратов IC50 (3,3 мг/мл) получена только для раствора аскорбиновой кислоты. Несмотря на относительную редкость первичной внутриглазной злокачественной медуллоэпителиомы, необходимо проводить дифференциальный диагноз с другими внутриглазными образованиями, прежде всего ретинобластомой. Полученные данные об эффективности раствора аскорбиновой кислоты в отношении клеток внутриглазной злокачественной медуллоэпителиомы могут быть использованы для дополнения существующих химиотерапевтических протоколов в детской нейро- и офтальмоонкологии.В работе представлен клинико-морфологический анализ случая первичной внутриглазной злокачественной медуллоэпителиомы редкой локализации — центрального отдела сетчатки с вовлечением диска зрительного нерва, — симулирующей ретинобластому, у ребенка 2 лет. Подробно приведены гистологические особенности опухоли (трубчатые и сетчатые структуры опухоли, розетки, ленточные образования, клетки с гиперхромными ядрами, клеточный полиморфизм). Описан единственный на сегодняшний день в Российской Федерации опыт создания первичной культуры внутриглазной злокачественной медуллоэпителиомы с последующей оценкой чувствительности (МТТ-тест) к четырем препаратам (оксалиплатин, иринотекан, ифосфамид, аскорбиновая кислота) в различных концентрациях. Из четырех исследованных препаратов IC50 (3,3 мг/мл) получена только для раствора аскорбиновой кислоты. Несмотря на относительную редкость первичной внутриглазной злокачественной медуллоэпителиомы, необходимо проводить дифференциальный диагноз с другими внутриглазными образованиями, прежде всего ретинобластомой. Полученные данные об эффективности раствора аскорбиновой кислоты в отношении клеток внутриглазной злокачественной медуллоэпителиомы могут быть использованы для дополнения существующих химиотерапевтических протоколов в детской нейро- и офтальмоонкологии.

The paper presents an integrated analysis of clinical, instrumental, and morphological data on a very rare pathological condition-- simultaneous ocular and orbital involvement in a lymphoproliferative disorder.В статье представлен полный клинический, инструментальный и морфологический анализ крайне редкого патологического состояния - сочетанного поражения глаз и орбиты лимфопролиферативным процессом.

The review concerns corneal nerves involvement in diabetes mellitus (DM), a pressing issue for ophthalmology and endocrinology. The history of research in this field along with anatomical, physiological, and biochemical features of corneal nerves is provided. Corneal nerves anatomy is described in accordance with Soviet scientific school and contemporary foreign sources. The most part of the paper is devoted to technical description of a confocal microscope and Heidelberg Retina Tomograph with corneal module as well as the feasibility of corneal nerves visualization. Diabetic neuropathy, a threatening complication of DM that can result in lower limb amputations, is discussed. A number of authors suggest confocal biomicroscopy for early diagnosis of polyneuropathy, yet few relevant publications can be found. If effective, confocal biomicroscopy can be considered as a possible screening tool able to detect early signs of diabetes complications and thus to ensure the treatment initiated in a timely manner. The latter is crucial to prevent DM progression to its terminal stage--diabetic polyneuropathy, which is dangerous of lower limb amputations.Обзор литературы посвящен актуальной проблеме офтальмологии и эндокринологии - состоянию нервов роговицы при сахарном диабете. Приведены исторические факты изучения данной проблемы, особенности анатомии, физиологии и биохимического состава нервов роговицы. Анатомия нервов роговицы описывается с позиции Советской школы офтальмологов, а также по данным современных зарубежных источников. Значительная часть обзора затрагивает описание конфокального микроскопа и аппарата HRT со специальной роговичной насадкой, а также возможность визуализации роговичных нервов при развитии сахарного диабета. Описывается появление грозного осложнения сахарного диабета - диабетической полинейропатии, приводящей к ампутации нижних конечностей. Ряд авторов предлагают использование конфокального микроскопа для ранней диагностики диабетической полинейропатии. При оценке данных литературы нами было отмечено наличие небольшого количества письменных работ, посвященных данной проблеме. Предположение, что метод конфокальной биомикроскопии действительно эффективен в ранней диагностике диабетической полинейропатии, дает возможность надеяться на использование данного метода в качестве скрининговой манипуляции, что позволит выявить осложнения еще на самых ранних этапах развития заболевания. Это, в свою очередь, будет способствовать своевременному началу терапии и предотвращению развития терминальной стадии сахарного диабета - диабетической полинейропатии, приводящей к ампутации нижних конечностей.

Uveal melanoma is a malignant intraocular tumor associated with poor vital prognosis, process generalization, and death from metastatic disease. A number of factors are considered undesirable in the presence of a tumor. This paper provides a review of the literature on major prognostic factors for uveal melanoma development and their contribution to vital prognosis.Увеальная меланома - злокачественная внутриглазная опухоль с плохим витальным прогнозом, приводящая к генерализации процесса и смерти больных от метастатической болезни. Существует ряд факторов, оказывающих неблагоприятное воздействие на течение опухолевого процесса. Настоящая работа представляет обзор литературы по основным прогностическим критериям увеальной меланомы и их значимости для витального прогноза заболевания.

The paper provides current knowledge on cataract epidemiology worldwide and in the Russian Federation, including issues of cataractogenesis and prevention. An overview of medical equipment for preoperative and intraoperative diagnostics is provided. Key aspects of the conventional ultrasonic phacoemulsification method as well as the most marked trends in correction of aphakia with intraocular lenses and in design of the latter are presented. Major laser-assisted techniques, including those that imply the use of femtosecond laser systems, and results that they yielded to date are discussed in detail.

Anatomical and physiological ocular surface barriers are responsible for low bioavailability of topical ophthalmic drugs. The unique structure of the cornea, epithelial cells and hydrophilic stroma in particular, impedes permeation of hydro- and lipophilic drugs via common routs of administration. The tear film with its proteins and enzymes also acts as a barrier. Despite several corneal transporters that take part in permeation of some drugs, increasing bioavailability of ophthalmic drugs in general remains a question of current importance. Liposomes are an option. These vesicular structures consist of the outer lipid bilayer and the inner aqueous compartment, which can be filled with a medication solution. This peculiarity of liposomes ensures their penetration through both hydro- and lipophilic mediums of the eye, including the barriers of the anterior and posterior segments. Liposomes are effective means of vectored drug delivery into the anterior chamber. This paper presents a review of the current knowledge on the interaction of drugs and ocular surface barriers as well as the prospects for the use of liposomes for transcorneal drug delivery.

Idiopathic epiretinal membrane is a result of a complex biomechanical interaction of the retina and vitreous. This paper discusses classification problems, epidemiological data of multicenter studies, and current hypotheses of epiretinal membrane pathogenesis.

The paper discusses literature data on the effectiveness of laser iridectomy in patients with primary angle-closure glaucoma. The main methods of anatomical and functional assessment and changes evaluation are reviewed.

The paper presents a complete clinical, instrumental, histopathological, immunohistochemical, cytological, and molecular-genetic testing of intraocular schwannoma in a 13-year-old girl.

The paper presents an up-to-date review of scientific data. Diabetes mellitus (DM), due to its epidemic prevalence and high occurrence of associated disability, is now one of the priority medical and social problems. Incapacitating manifestations of diabetes include visual impairment. Thus, diabetic retinopathy (DR), a late nonspecific vascular complication of DM, is the leading cause of blindness in the working-age population. The basic principle of DR treatment is optimal compensation of diabetes and concomitant conditions, such as arterial hypertension, nephropathy, and hyperlipidemia. Tight glycemic control is the main method for preventing and slowing the progression of preproliferative DR to later stages. Currently, the optimal and the most promising method of insulin injection to diabetes patients is insulin pump, as it enables accurate imitation of physiological secretion of insulin, provides the possibility of tight glycemic control, considerably decreases the risk for acute and late complications of diabetes, etc.

Up-to-date aspects of ocular changes in systemic atherosclerosis are reviewed. At the present time despite of wide use of current methods of ocular blood circulation and retina examination there are no papers that allow to estimate dynamics of impairment of visual functions from different viewpoints (clinical, functional, blood flow, morphological etc.) in initial isolated ocular atherosclerosis. Etiology, pathogenesis and ideas about potential effect of systemic atherosclerosis on the eye are discussed. Features of blood flow in optic nerve head compared to retinal vessels are described. According to the last data correlation between the degree of reduction of a-wave of scotopic electroretinogram and deterioration of haemodynamic parameters exists.

Methods of conservative treatment of amblyopia are presented in the review. The paper includes information about pleoptics, physiotherapy, pharmacotherapy and examples of combined treatment of the amblyopic eye. Analysis of literature shows that this problem is an issue of concern and further research is needed.

The paper presents the results of studying the effect of 10% perfluorane (PF) emulsion intravenously injected 1-2 days before surgical treatment for rhegmatogenous retinal detachment on the levels of the cytokines IL-1beta, TNF-alpha, IL-6, and IL-4 in the serum and subretinal fluid of patients. PF infusion was found to exert an immunomodulatory effect that favored a short-term increase in the serum level of proinflammatory cytokines (IL- 1beta and IL-6) at week 1 and TNF-alpha on day 1) with their gradual normalization. The subretinal fluid showed recovery of the mechanisms for local immunological reactions; eye inflammation reduced due to the decreased production of proinflammatory cytokines and simultaneously the elevated level of the anti-inflammatory cytokine IL-4.

The paper presents an anterior stromal puncture method that is used to treat recurrent corneal erosion and painful bullous keratopathy. The mechanisms of action of anterior stromal puncture as a technique used alone and in combination with amniotic transplantation and indications for the application of this method are described.

The paper gives the comparative results of infrared exposure, drug and multimodality treatment in partial optic nerve atrophy of varying degrees, as evidenced by Doppler, electrophysiological, and morphometric studies.

The paper analyzes outpatient cards of 415 patients who underwent enucleation for uveal melanoma (UM) in 1962-2008 and who have been registered in the Moscow City Ophthalmology Center since 1990. The patients' mean age was 58.94 +/-1.29 years. During the follow-up, 56 patients died 5.24 +/- 1.84 years postoperatively. The distribution of UM by the histological types was as follows: spindle cell (n = 275; 66.27%); mixed cell (n = 100; 24.09%), and epithelioid cell (n = 26; 6.27%) UM. Eleven (2.65%) patients were diagnosed as having necrotic melanoma. Poor (preequatorial and juxtapapillary) position was observed in 35.4% of the patients. Mortality in patients with UM after enucleation was 14.44% with a life expectancy of 5.24 +/- 1.84 years. The findings make it possible to recommend that an enucleation procedure should be developed, by concurrently forming a locomotor stump, which promotes the improvement of the results of individual cosmetic prosthetics in patients with UM that is not to undergo organ-saving treatment.

This paper analyzes the data available in the literature on the incidence of uveal melanomas. It historically describes enucleation and the specific features of its performance in patients with and without uveal melanoma. The specific features of enucleation in patients with uveal melanoma, indications for locomotor stump formation, and procedures for calculating the parameters of an implant are considered. Analysis of the data available in the literature shows that there is presently no unambiguous opinion as to the most rational enucleation modes and as to the capacities and types of used implants as a whole. This primarily applies to enucleation used in patients with intraocular neoplasms.

The current methods widely used in ophthalmology to examine patients to diagnose the dry eye syndrome and to trace the course of a process are invasive. Both the Norn test using stains and the Schirmer test with the filter paper strips being inserted are stimuli that affect the rate of tear generation, which misrepresents the data obtainable. The developed procedures for examining the eye in polarized light permit one to considerably reduce the invasiveness of patient examination. The study indicated the high efficiency and diagnostic value of the proposed procedures in the examination of patients with the dry eye syndrome. Polarization filters available in the standard kit of up-to-date slit lamps make it possible to use the proposed procedures without any modification of ophthalmological equipment in wide clinical practice.

The paper presents the results of practical application of a new screening method for determining tolerant intraocular pressure (TIOP) on a Blood Flow Analyzer (Paradigm, USA). Studies were conducted on 331 eyes (205 subjects). Group 1 consisted of 80 patients (126 eyes) without glaucoma being found, with intraocular pressure (IOP) in the average normal range, but with a TIOP excess of 1-8 mm Hg (a risk group); Group 2 included 15 subjects (20 eyes) without glaucoma with normal IOP in whom TIOP exceeded the existing IOP by 1-7 mm Hg; Group 3 comprised 110 patients (185 eyes) with Stage I-III primary open-angle glaucoma (POAG) with compensated IOP. Morphofunctional studies revealed glaucoma in 95 (75%) eyes in the risk group: Stages II and I in 61 and 30%, respectively; and advanced glaucoma in 9%. At the same time, there was a close correlation of the probable detection of glaucoma with the existing degree of a TIOP excess. No cases of glaucoma were observed in Group 2. The determination of TIOP and morphofunctional changes over time in Group 3 revealed a stable glaucomatous process in 99% of cases in which IOP was lower than or equal to TIOP, as well as progressive glaucomatous neuropathy in 91% in which compensated LOP exceeded TIOP. The results of the study in Group 3 suggest that the index TIOP may be used as a guide of IOP in the treatment and monitoring of POAG. The presented data indicate that the determination of the level of TIOP is a required element of both standard ophthalmological examination and monitoring of glaucoma.

The outcomes of keratitis in lagophthalmos occurring due to various causes despite therapeutic measures are generally poor. The influence of factors, such as drying of the cornea, impairment of its trophism, and infection, leads to the development of rough leukomas, and occasionally to eye death due to occurring endophthalmitis. The paper describes a clinical case of deep trophic central corneal ulcer on the single seeing eye with lagophthalmos, as well as ulcer treatment by the authors' procedure, by simultaneously affecting both elements of the pathology (lagophthalmos and trophic ulcerative keratitis of central localization) and creating an artificial pupil. This allows one to increase visual acuity, to cure keratitis, and to close a palpebral fissure.

The paper reviews the currently available methods for studying the lens. It describes the anatomic and functional features of the lens and the principles of its examination based on biomicroscopy, photorecording, etc. It also depicts quantitative methods for assessing the properties of the lens: the use of multifunctional devices in which the Scheimpflug principle is realized; methods based on the application of ultrasound energy (A-scanning, B-scanning, biomicroscopy).

The paper gives an algorithm for qualified care given to victims in the first hours and days after the moment of ocular injury. It outlines resuscitation of a severe injured eye and a possibility of combating any complications of traumatic disease at the present stage. Based on their many years' experience, the authors have developed and present a multifaceted system of measures to provide the victim with intensive care in combination with adequate surgical and pharmacotherapeutic correction, which enables one to preserve the organ of vision and to have good functional and cosmetic results, which is of not only great clinical, bur also social value.

The paper touches upon the specific features of the anatomic structure and biophysical properties of the whole eye and its individual structural elements. The Russian and foreign sources characterizing a wide range of the biological, biochemical, and physical properties of morphological elements constituting the eyeball are analyzed. The significance of individual analyzed characteristics for the formation of a three-dimensional ultrasound image is assessed.

The paper analyzes recent literature and the authors' experience in treating choroidal melanoma with transpupillary thermotherapy. Analysis of the results of treatment in 30 patients shows the efficiency of the technique only the tumor is less than 2 mm thick. When the latter is larger, transpupillary thermotherapy may be used only in combination with brachytherapy. Risk factors worsening the efficiency of thermotherapy are defined. These include tumors that are more than 2 mm thick or slightly pigmented, and the presence of a subretinal exudate. The frequency and severity of complications were estimated after transpupillary thermotherapy. The occurrence of complications and their pattern depend on the baseline sizes of choroidal melanoma, the number of performed sessions, and previous treatment (local tumor resolution). Comparison of the data available in the literature and the authors' experience made it possible to define clear indications for transpupillary thermotherapy in order to treat choroidal melanomas and to identify factors promoting the prevention of possible complications.

The paper touches upon the specific features of the structure of orbital formations, by considering their anatomic topography and biophysical properties. By studying the results of investigations of the morphological and biophysical studies of orbital tissues, the authors analyze their features and compare their relationships. These results unraveling each of the considered orbital anatomic elements from the acoustic profile ranges may be useful in understanding the nature of clinical changes, which will be able to interpret these or those diagnostic signs--guides and to trace their evolution. In addition, this approach can help interpret the texture of an ultrasound digital image of eye socket soft tissue and permit one to look at pathological clinical manifestations from the so-called biophysical essence. This will allow additional information to be gleaned, by analyzing the usual signs.

The paper presents a detailed analysis of 27700 patients with ocular injury who received a therapeutic-and-diagnostic care at the first specialized stage. The specific features of an oculist's care in an intensive care unit and the required volume of diagnostic studies in different types of posttraumatic pathology of the eye and its appendages are defined. Indications for emergency hospitalization in fresh trauma and sequels are presented. Algorithms of treatment have been developed and are recommended in relation to the pattern and severity of injuries of the organ of vision.

The paper gives the results of a study of ocular optical aberrations in keratoconus. Objective aberrometry was carried out with OPD Scan (Nidek, Japan). An additional computer program (OPD station) was used to evaluate the corneal wavefront. Examinations were made before and after application of a rigid gas-permeable lens (RGPL) to the eye. For the functional evaluation of the effectiveness of contact correction, the investigators used visometry and determined binocular visual functions, contrast sensitivity, and visual productivity. A total of 87 subjects (174 eyes) with keratoconus were examined. Stage 1 disease was found in 48 eyes, Stage 2 in 49 eyes, Stage 3 in 37 eyes, and Stage 4 in 40 eyes. Analyzing the results of the study could evaluation the effectiveness of keratoconus correction with RGPL. The use of the latter presents a possibility of compensating for optical aberrations, achieving their reduction practically to the one level irrespective of the stage of keratoconus with a slight increase in Stage 4 disease. In Stages 1-3, the mean aberration values of each type have very close values (without statistically significant differences between them). In Stage 1 keratoconus, RGPL can completely compensate for high-order corneal aberrations (including coma, trefoil, and spherical aberrations). Normalization of the wavefront promotes the achievement of high functional results of contact correct of refraction disorders in keratoconus, by applying RGPL.