Accommodation Disorders Research Articles

A new method for quantifying accommodation parameters based on objective dynamic accommodometry

Purpose: to develop a technique for an objective multifactorial assessment of accommodation parameters, including accommodation stability and microfluctuations (MF), and an assessment of the diagnostic value of the technique. Material and methods. The dynamic monocular accommodative response (MAR) was measured using a WAM-5500 device (Grand Seiko, Japan) over a period of 10 to 60 seconds with a recording frequency of at least 6 Hz. The approximating cubic spline was calculated, and the temporal change of signal trend was assessed. The developed technique was used to evaluate the dynamics of MAR for 46 eyes of 23 patients aged 8–12 years with acquired myopia from -0.87 to -5.75 D (ave. -2.96 D). Results. In the examined eyes, the MF frequency varied from 0.4 Hz to 2.3 Hz (ave. 1.4 Hz), and the maximum amplitude ranged from 0.4 D to 2.47 D (ave. 1.2 D). Over the research period, the MAR trend remained constant in 10 eyes, increased from 0.17 to 0.47 (ave. 0.29 D) in 8, and decreased from 0.1 to 1.53 D (ave. 0.35 D) in 28 eyes. MAR varied from 0.79 to 2.63 (ave. 1.8 D). A correlation was found between the minimum MAR and the signal range with the trend level (r= 0.29 and r=0.4, respectively) and a weak correlation was revealed between the MF frequency and the signal range (r=0.2). A set of criteria for accommodation instability was identified: a decreasing trend of more than 0.35 D, a MF frequency of more than 1.4 per second and/or a maximum signal span of more than 1.2 D. Conclusion. The developed technique or objective multifactorial assessment of accommodation parameters, including stability and MF, in real time and space proves to be useful for the diagnosing of accommodation disorders.

PRESERVING THE HEALTH OF THE ORGAN OF VISION IN CHILDREN: ORGANIZATIONAL PRINCIPLES

Background. The relevance of the study is due to the growing prevalence of ophthalmic pathology among children, in particular, the growing prevalence of refractive errors in early and older adolescence. The results of scientific research prove the presence of a direct correlation between the growth of the prevalence of ophthalmic pathology and the growth of the child's age and the amount of visual stress, which is primarily related to the educational process during school education. The effective organization of medical care should take into account modern medical and preventive technologies of early preventive intervention, as well as be comprehensive with the involvement of medical specialists (pediatric ophthalmologists, family doctors) and educators, family members, parents of the child for effective support and leveling of managed risk factors for the development of ophthalmic pathology.
 Aim: to study the modern organizational principles of preserving the health of eye care of children, to clarify the medical and social aspects of the formation of the burden of ophthalmic pathology from childhood in different countries of the world.
 Materials and methods. The materials for the research were publications of the results of modern scientific research on the study of medical and social aspects of preserving the ophthalmic health of children, the peculiarities of the organization of providing medical and preventive care to children with visual impairments. The methods for carrying out scientific research were: system approach and system analysis, as well as content analysis.
 Results of the study prove the prospects for the implementation of medical and preventive strategies in the provision of primary and specialized ophthalmic medical care, in view of the significant medical and social burden of ophthalmopathology, the distribution of nosologies by class of diseases of the eye and its accessory apparatus, which are most often found in certain age groups of the children's population, is presented. It has been proven that compliance with the optimal periodicity of medical and preventive examinations is necessary for the majority of ophthalmological nosologies diagnosed since childhood and involves long-term supervision. In children of preschool, preschool and early school age, efforts at early prevention and diagnosis of such ophthalmological nosologies as: refraction anomalies (astigmatism, hypermetropia, myopia) are justified. strabismus and amblyopia; accommodation disorders; lack of convergence. Untreated or untimely detected refraction anomaly, strabismus, amblyopia can lead to the development of irreversible loss of visual functions, blindness and even inhibition of the formation of the visual system with distorted perception of visual information, which without timely correction lead to the appearance of complications, progression of strabismus, decrease in visual acuity, amblyopia , asthenopia, headache and deterioration of general well-being.
 Conclusion. The important medico-social importance of disorders of visual functions in childhood is a serious problem for the health care system, public health and ophthalmology service, in particular. Reasoned expediency of applying measures to level the managed risk factors against the background of intersectoral interaction of doctors, educators, the child himself and his family. This approach allows you to prevent the negative impact of ophthalmic pathology on academic performance, activate physical development, and promote harmonious personality development.

Changes in accommodation disorders in children with anisometropic amblyopia and hypermetropia

Background. Accommodation disorders in children with hypermetropia is one of the main factors in emmetropization disorders and maintenance of image defocusing. The most severe changes in accommodation are observed in children with anisometropia and hyperopia.The aim of the work. To evaluate the changes in the accommodative function of the eye in children with hyperopia, amblyopia, who underwent refractive laser surgery (RLS), as well as in children with spectacle and contact lens correction in combination with pleoptic treatment.Methods and materials. Group 1 consisted of 30 children after RLS; group 2 consisted of 29 children who had spectacle correction; group 3 consisted of 26 children who had soft contact lens correction; all children received pleoptic treatment. Clinical examination included the analysis of objective reserves of relative accommodation (RRA) and objective accommodative response (OAR) with an open field autorefractometer, and the results of accommodation measurement.Results. In 1.5 years, statistically significant changes were observed in the coefficient of accommodation response (CAR) of the amblyopic eye between the groups 1 and 2 – 0.12 ± 0.02 and 0.00 ± 0.1 relative units, respectively (p = 0.01). Similar statistically significant changes were obtained in OAR and objective RRA of the amblyopic eye. OAR in the group 1 was –2.1 ± 0.67 dpt, in the group 2 – –1.38 ± 0.19 dpt (p = 0.01). At the end of the observation, the OAR in the group 1 was –2.1 ± 0.67 dpt, the objective RRA – –2.1 ± 0.67 dpt; in the group 2 the OAR was –1.38 ± 0.19 dpt (p = 0.01), the objective RRA – –1.38 ± 0.19 dpt (p = 0.01). There were no statistically significant changes in these parameters of the amblyopic eye between the groups 1 and 3.Conclusion. There was an improvement of accommodation disorders in children with anisometropia, hyperopia and amblyopia after refractive laser surgery and in children with contact lens correction. Due to a decrease in the refractive indices of the amblyopic eye, the values of CAR, OAR and objective RRA after refractive laser surgery tended to be closer to the normal values.

Gastric accommodation: pathogenetic role and clinical significance

The article presents a literature review of modern Russian and foreign publications devoted to the study of gastric accommodation. It has been shown that accommodation of the proximal stomach plays an important role in its adaptation to food intake. This process is carried out in two stages with the participation of parasympathetic and paracrine regulation; the effects of nutrients when they enter the duodenum also play an important role. Methods for assessing gastric accommodation include gastric barostat, gastric scintigraphy with food load, drinking tests, single-photon emission computed tomography, magnetic resonance imaging and ultrasound examination of the stomach, intragastric manometry. Violation of gastric accommodation leads to an excessive increase in intragastric pressure and the occurrence of symptoms most often found in functional dyspepsia, gastroesophageal reflux disease and diabetic gastropathy. Approaches to the treatment of gastric accommodation disorders are at the development stage, the possibilities of diet therapy, pharmacological and non-drug correction are being discussed.

Гиперметропия у детей и ее клинические особенности

Purpose. Assessment of the functional state of children with hypermetropia and its performance in the visual system. Material and methods. 212 (424 eyes) somatically healthy children aged 3 to 18 years with hypermetropic refraction from 1.5±0.6 to 7.5±0.7 D were examined. They underwent standard ophthalmological examination, including visometry, refractometry, biometry and keratometry. The statistics of the material were processed according to the MS Excel 2010 program. Results. Structure of hypermetropic children for various periods of life is described in detail – congenital (against the background of normal physiology), acquired and concomitant (in various variants). In addition, the axial length of their eyes was determined in the range from 21.0 to 23.85 mm, that is, in a short range. It is also clarified that hypermetropic children can not only determine the «regular» eye accommodation tension, but also timely detect and treat functional disorders – asthenopia and/or habitually excessive accommodation voltage (described by Somov E.E. in 2012). It is also confirmed that hypermetropia is naturally accompanied by friendly strabismus (at least 90%). However, this diagnosis reveals various forms of pathology of the visual organ – deviation of the eye, ametropia, amblyopia and dysbinocularity. It can be represented by the syndrome of friendly strabismus (SFS, Somov E.E.). Two clinical forms of hypermetropia have also been identified – ordinary and complicated. The first does not require treatment, apart from optical vision correction, and the second is described in different publications, due to accommodation disorders, friendly strabismus and amblyopia. Conclusion. Hypermetropia in children is represented by a complex anatomical and clinical structure with a short axial length of the eye, weak optics, functional disorders of accommodation (asthenopia and/or habitually excessive accommodation voltage). Moreover, it naturally occurs with the syndrome of friendly strabismus. Finally, due to anatomical features, hypermetropes are able to use only «simple» vision correction: traditional glasses (~75%), contact lenses (~25%) and still rare Perifocal-H lenses. In general, these ametropes require a lot of attention, especially in conducting new research. Key words: clinical refraction of the eye, anterior-posterior eye size, keratorefractometry, accommodation, commutant esotropia, vision correction in hypermetropia

Mining and analysis of adverse event signals of Cariprazine based on the real-world data of FAERS database

ObjectiveThis study aims to analyze the adverse events (AEs) of Cariprazine based on the FAERS database, providing evidence for its safety surveillance. MethodsFor signal quantification of Cariprazine-related AEs, we used disproportionality analysis including the Ratio of Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma Poisson Shrinker (MGPS) algorithms. ResultsWe selected Cariprazine-related AE reports from the FAERS database from the fourth quarter of 2015 to the first quarter of 2023, and performed a detailed data analysis. Out of a total of 12,278,580 case reports, 3659 were found to be directly related to Cariprazine. We identified 140 Preferred Terms (PT) to describe these AEs, finding that they involved 27 organ systems. Specifically, AEs related to eye disorders such as Cataract cortical, Cataract nuclear, Accommodation disorder, Lenticular opacities, Oculogyric crisis, Dyschromatopsia were not explicitly mentioned in the drug's leaflet, indicating the presence of new ADR signals. ConclusionAnalysis of the FAERS database identified AEs associated with Cariprazine, notably in eye disorders not previously documented in the drug's official leaflet. These findings emphasize the need for continuous post-market surveillance and awareness among healthcare professionals regarding potential new ADR signals.

The Relationship between Anxiety, Visual Function, and Symptomatology in University Students.

Mental health concerns have emerged at the university level, with the psychological well-being of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 ± 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test ("no anxiety" and "anxiety" groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorders.

Состояние рефракции школьников 9–17 лет

Аccording to rOSstat, the incidence of diseases of the eye and its adnexa is about 5–6.0 % both in children aged 0–14 years and in adolescents aged 15–17. Purpose. to identify the age and gender characteristics of refraction state in schoolchildren. Material and methods. a survey of 1215 children aged 9–17 years was performed. the examination included: filling out a questionnaire, autorefractometry, assessment of uncorrected visual acuity and best corrected visual acuity with the existing correction. Results. Both sexes were characterized by a tendency to decrease in refraction from 9 to 12 years, but in girls it was more pronounced. When conducting a correlation analysis between age and refraction values in boys, a statistically significant (p < 0.05) feedback of weak strength was revealed (Spearman’s r = –0.17). In boys, the analysis of uncorrected visual acuity revealed its decrease at the age of 9 to 14 years. girls, starting from the age of 11, statistically significantly differ from boys in lower values of visual acuity. among all examined children, accommODation disorders were found in 17 % of the examined children. there is a tendency to increase the frequency of accommODation disorders from the age of 12. Some subsequent decrease in vision is pOSsible due to further deterioration of the condition and the transition of some children with accommODation disorders to the group of children with myopia. Conclusion. 1. more frequent provision of corrective glasses for girls was revealed. 2. a significant increase in the tendency of accommODation disorders was revealed at the age of 12. 3. With age, the frequency of myopia increases, but among girls it is more common. 4. the need for glasses in general in children of all ages was 47 %, and the satisfied need for glasses was only 32 %. Keywords: refraction, myopia, hypermetropia, anisometropia, schoolchildren’s vision, visual acuity, provision with glasses

Accommodation disorders in patients with visually intensive labor before LASIK in myopia (clinical cases)

Laser keratomileusis in situ (LASIK) is the most common refractive surgery in young patients, the goal of which is to provide high distance vision without the use of glasses. One of the topical aspects of assessing the clinical effectiveness of LASIK is the dynamics of the accommodative function of the eye, which is a professionally significant function of the visual analyzer in patients with visually stressful work (VSW). Three clinical cases are presented, reflecting various states of accommodation (normal, habitual excessive tension of accommodation, asthenic form of accommodative asthenopia), diagnosed (based on the method of objective accommodation and the "quality of life" questionnaire "Computer visual syndrome — 22" in patients with VSW before LASIK. It was determined that that LASIK for various degrees of myopia in patients with VSW requires a comprehensive consideration from the standpoint of diagnosis and (or) correction of accommodative asthenopia based on a personalized approach that takes into account the main types of asthenopia. Correct diagnostics provides adequate treatment from the standpoint of choosing both the actual method (physical factor) and the required optical, amplitude and time parameters of exposure.

Modern aspects of diagnosis and treatment of subjective manifestations and accommodation disorders in patients — professional users of personal computers (systematic review)

A systematic review was performed in the RSCI and PubMed databases using the following keywords: Computer vision syndrome, Digital eye strain, Accommodation, Accommodative asthenopia, RTS, and Quality of life. Eligible articles were evaluated in accordance with the criteria for prospective or retrospective studies. A total of 792 sources were analyzed, further using systematic review filters and authors knowledge of the topic. The retrospective analysis spanned 7 years (20162022). Data indicated that accommodative asthenopia (AA), as a functional visual disorder, is a natural state of the accommodative system of the eye caused by long-term exposure to visually intense work on a personal computer. AA is characterized by a wide range of subjective manifestations (complaints) and indicators of the examination of the patients vision, associated primarily with objective accommodation. A differentiated approach to the diagnosis of various forms of AA, such as habitual excessive stress of accommodation and asthenic form of accommodative asthenopia, is important to provide adequate treatment based on methods with direct physical effects on the eye (such as low-energy laser radiation, magnetophoresis, and stimulation of accommodation), opto-reflex treatment, and an outpatient course as part of home training.

Femtosecond Laser-Assisted In Situ Keratomileusis for the Treatment of Moderate to High Hyperopia.

Report modern outcomes of femto-LASIK for the correction of moderate-to-high hyperopia (≥3.50 and ≤6.50D), excluding low or very high hyperopia. Vissum, Alicante, Spain. Monocentric retrospective case series study. Visumax-500kHz femtosecond-laser, and Amaris-750 excimer-laser were used. Eyes with at least 6-months of follow-up were included. 36-month data was collected when available. Primary outcome measure was short term efficacy and safety. Secondary outcome measure was long term stability. Six-month data of 92 eyes was collected (68 eyes at 36 months). Mean age was 34.6±10.4 years. Mean treated sphere was 4.69±0.87. Efficacy index was 0.91 and 0.90 at 6 and 36 months respectively. Safety index was 1.00. UDVA was 20/20 or better in 72%, postop spherical equivalent within 0.5D in 80% (93% within 1D), and loss of one line of CDVA occurred in 13% (2 or more lines in 0%). Gain of 1 or more CDVA lines occurred in 17%. A slight but significant regression was observed at 36 months. Postoperatively, 21.73% required flap lift for laser enhancement, and 11.95% an orthoptic visual rehabilitation due to accommodative disorders. Modern LASIK provides good efficacy and safety levels for the management of moderate to high hyperopia (up to +6.5D), with levels close to those previously reported with refractive lens exchange for young hyperopia patients without presbyopia, where we defend the maintenance of LASIK as first line therapy. Risk of requiring a refractive enhancement or an orthoptic visual rehabilitation remains relevant and needs to be discussed with patients preoperatively.

Особенности формирования и течения поздно приобретенной миопии

Introduction. In the modern world, the load on vision has significantly increased, the widespread introduction of computer technology has led to additional visual load, both during working hours and at home. Prolonged and strenuous visual work can lead to the emergence of professional ophthalmopathy, one of the leading manifestations of which is myopia, which develops in persons with visually strenuous work. Goal. To investigate the features of the formation and course of myopia in adults. Material and methods. A retrospective study was conducted based on ophthalmological examination data during the medical examination of the attached contingent in the period 2020-2023 (n=1506). Among them there were 1202 men (79.8%) and 304 women (20.2%). During the examination 416 people (27.6%) were found to be healthy. Refraction and accommodation disorders were detected in 1076 people (71.6%), other visual diseases – in 14 people (0.8%). Among the violations of refraction and accommodation, the leading (50.3%) were: myopia (29.9%), myopic astigmatism (17.6%) and mixed astigmatism (2.8%). The age at which myopia occurred, the degree of clinical refraction, the rate of progression, and the magnitude of anisometropia were evaluated. Results. In 153 people (20.2%), myopia manifested at the age of 34.3+7.2 years (18;52). At the time of examination, the duration of myopia was 7.3+5.9 years (0; 30). In the period 2020-2021, the proportion of late myopia left 14.0%, and in 2022-2023 – 28.8% (p<0.001). Stationary course of late myopia was noted in 5.9% of cases, progression – in 90.2% (slow (0.5 dptr per year or less) – 77.8%; fast (more than 0.5 dptr per year – 7.2%). The proportion of mild myopia was 92.9%, medium – 6.5%, high – 0.7%. Isometropia was observed in 44.4% of cases, anisometropia up to 0.5 dpt – in 34.7% of cases, anisometropia with a degree of 0.75 dpt and more – in 20.9% of cases Conclusion. During the medical examination, 71.6% of the examined contingent revealed violations of refraction and accommodation, including 50.3% of individuals diagnosed with myopic refraction. Nearsightedness manifested at the age of 18 and older was observed in 20.2% of people with myopia. The data obtained confirm the need for therapeutic and preventive measures to prevent the formation and progression of myopia in adults. Keywords: myopia, adults, professional ophthalmopathy, refraction, accommodation

Accommodative disorders in non-presbyopic subjects with type 1 diabetes without retinopathy: A comparative, cross-sectional study.

The purpose of this study was to assess accommodative function in non-presbyopic individuals diagnosed with type 1 diabetes (T1D) without any signs of retinopathy, to determine the existence of possible accommodative disorders related to this disease, and to determine the influence of T1D duration and glycosylated haemoglobin values on accommodative function. This comparative, cross-sectional study included 60 participants between 11 and 39 years old, 30 with T1D and 30 controls, with no previous eye surgery, ocular disease or medication that could affect the results of the visual examination. Amplitude of accommodation (AA), negative and positive relative accommodation (NRA and PRA), accommodative response (AR) and accommodative facility (AF) were assessed using the tests that showed the highest repeatability. Participants were classified based on normative values into 'insufficiency, excess or normal results', and a diagnosis of accommodative disorders (accommodative insufficiency, accommodative infacility and accommodative excess) was made. Participants with T1D had statistically significant lower AA and AF and higher NRA values than the controls. Furthermore, AA was significantly and inversely correlated with age and the duration of diabetes; however, AF and NRA were only correlated with disease duration. In the classification by accommodative variables, a higher percentage of 'insufficiency values' was observed in the T1D group (50%) than in the control group (6%; p < 0.001). In terms of accommodative disorders, accommodative infacility was the most prevalent (15%), followed by accommodative insufficiency (10%). Our findings indicate that T1D affects most accommodative parameters, with accommodative insufficiency being associated with this disease.

Предикторы аккомодационной астенопии у пациентов зрительно-напряженного труда с явлениями компьютерного зрительного синдрома

Purpose. Investigation of the relationship between the indicators of the visual system of patients with visually stressful labor (VLT) and the diagnostic criteria for accommodative asthenopia (AA). Material and methods. 300 patients were examined (mean age 29.4 ± 1.2 years, the presence of myopia in terms of spherical equivalent value (SE) from 1.5 diopters to 8.0 diopters), whose professional daily activities (at least 2 years) are characterized by as VLT with a personal computer (PC). A comprehensive examination of the state of vision was performed according to clinical, functional, subjective and ophthalmo-ergonomic indicators. A multiple regression analysis of 18 indicators of the functional state of the visual analyzer was performed with the parameter of objective accommodation – the coefficient of microfluctuations (CMF) as the basic diagnostic criterion for AA. The assessment of the level of reliability of the mathematical model (regression equation) was based on the calculation of the multiple coefficients of determination (R2). Results. The high (R2 = 0.71) predictive value of the developed mathematical model was determined. It has been established that CMF is closely interconnected (p &lt; 0.05–0.001) with clinical (uncorrected distance visual acuity, SE), functional (indicators of objective accommodography — coefficients of accommodative response, accommodogram growth, etc.), subjective (questionnaire «quality life» «KZS-22») and ophthalmo-ergonomic («Eye» test in conditions of time deficit of presentation of the test object) parameters of the functional state of the visual analyzer. The low information content of traditional methods for studying accommodation indicators (the volume of absolute and relative accommodation) has been determined. Conclusion. The identified parameters can be considered from the standpoint of predictors of accommodative asthenopia in patients with VLT associated with PC. At the same time, the leading indicator of screening diagnostics can be a study of the patient’s «quality of life» according to the «KZS-22» questionnaire, which allows clinically normalizing accommodation disorders from the standpoint of the states of «normal», «subcompensation» and «decompensation» of asthenopia. Keywords: visually stressful work, computer vision syndrome, accommodative asthenopia, objective accommodography, «quality of life»

MODERN TECHNOLOGIES FOR THE DIAGNOSIS AND TREATMENT OF DISEASES OF THE VISUAL ORGAN

The lecture highlights the morphofunctional organization of the visual sensory system. The structure of the organ of vision is presented, special attention is paid to the structures of the eye responsible for the conduction and perception of visible light. The features of the structure of the optical system of the eye, as well as the mechanisms of formation and circulation of aqueous humor in the eyeball are discussed. The prevalence of diseases of the organs of vision is shown and the most relevant types of pathology are highlighted. Modern high-tech diagnostic and therapeutic technologies used in diseases of the conjunctiva, dry eye syndrome, cataracts and glaucoma are highlighted. Modern individual optical devices for correction of accommodation disorders in adults and children (glasses, contact lenses, methods of refractive surgery) are shown.

Validity of Administrative Claims and Electronic Health Registry Data From a Single Practice for Eye Health Surveillance

Diagnostic information from administrative claims and electronic health record (EHR) data may serve as an important resource for surveillance of vision and eye health, but the accuracy and validity of these sources are unknown. To estimate the accuracy of diagnosis codes in administrative claims and EHRs compared to retrospective medical record review. This cross-sectional study compared the presence and prevalence of eye disorders based on diagnostic codes in EHR and claims records vs clinical medical record review at University of Washington-affiliated ophthalmology or optometry clinics from May 2018 to April 2020. Patients 16 years and older with an eye examination in the previous 2 years were included, oversampled for diagnosed major eye diseases and visual acuity loss. Patients were assigned to vision and eye health condition categories based on diagnosis codes present in their billing claims history and EHR using the diagnostic case definitions of the US Centers for Disease Control and Prevention Vision and Eye Health Surveillance System (VEHSS) as well as clinical assessment based on retrospective medical record review. Accuracy was measured as area under the receiver operating characteristic curve (AUC) of claims and EHR-based diagnostic coding vs retrospective review of clinical assessments and treatment plans. Among 669 participants (mean [range] age, 66.1 [16-99] years; 357 [53.4%] female), identification of diseases in billing claims and EHR data using VEHSS case definitions was accurate for diabetic retinopathy (claims AUC, 0.94; 95% CI, 0.91-0.98; EHR AUC, 0.97; 95% CI, 0.95-0.99), glaucoma (claims AUC, 0.90; 95% CI, 0.88-0.93; EHR AUC, 0.93; 95% CI, 0.90-0.95), age-related macular degeneration (claims AUC, 0.87; 95% CI, 0.83-0.92; EHR AUC, 0.96; 95% CI, 0.94-0.98), and cataracts (claims AUC, 0.82; 95% CI, 0.79-0.86; EHR AUC, 0.91; 95% CI, 0.89-0.93). However, several condition categories showed low validity with AUCs below 0.7, including diagnosed disorders of refraction and accommodation (claims AUC, 0.54; 95% CI, 0.49-0.60; EHR AUC, 0.61; 95% CI, 0.56-0.67), diagnosed blindness and low vision (claims AUC, 0.56; 95% CI, 0.53-0.58; EHR AUC, 0.57; 95% CI, 0.54-0.59), and orbital and external diseases (claims AUC, 0.63; 95% CI, 0.57-0.69; EHR AUC, 0.65; 95% CI, 0.59-0.70). In this cross-sectional study of current and recent ophthalmology patients with high rates of eye disorders and vision loss, identification of major vision-threatening eye disorders based on diagnosis codes in claims and EHR records was accurate. However, vision loss, refractive error, and other broadly defined or lower-risk disorder categories were less accurately identified by diagnosis codes in claims and EHR data.

Анализ состояния офтальмологического здоровья призывников в Военном комиссариате Ленинского и Свердловского административных округов города Иркутска Иркутской области

The article analyzes the medical examination of 7372 citizens when conscripted for military service in the military commissariat of the Leninsky and Sverdlovsk administrative districts of the city of Irkutsk, Irkutsk region for 2021–2022. In the structure of fitness for military service of persons of military age for 2021 and 2022, according to the articles of the schedule of diseases, article 34 (refraction and accommodation disorders) takes 1st place, article 31 (retinal detachment) takes 2nd place, and 35 (blindness, low vision, color vision abnormalities) takes 3rd place. Every second young man of military age has a violation of refraction and accommodation, in which myopia (myopia) plays a leading role. A combination of ophthalmic nosologies was found in 530 (13.6 %) conscripts. Keywords: ophthalmological health, medical examination, military service, conscript, ophthalmological nosology

Prevalence of Eye and Vision Disorders in the Military Health System, Fiscal Year 2018.

Eye and vision disorders are estimated to impact 7.08 million people in the United States, including 1.62 million under the age of 40. This study uses the Vision and Eye Health Surveillance System (VEHSS) case definitions to assess the burden of eye and vision disorders in a universally insured, nationally representative population. This retrospective, cross-sectional study applied the VEHSS case definitions to TRICARE claims data collected from the Military Health System Data Repository and Defense Enrollment Eligibility Reporting System during 2018. Beneficiaries aged 0-64 years during the fiscal year 2018 were identified with inpatient and outpatient codes matching to the VEHSS diagnostic case definitions, which were organized into 17 categories of eye and vision disorders classified by the ICD-10. Beneficiaries were recorded only once per category but allowed to match to multiple categories. Analyses included descriptive statistics of patient demographics and prevalence of eye disorders. We identified 4,548,897 TRICARE Prime/Plus beneficiaries (54.86% men and 45.14% women), of whom 22.93% were diagnosed with at least one disorder in 2018. Of those with a diagnosis, the majority were men (50.13%), adults (74.91%), and of or sponsored by a senior enlisted rank (57.83%), used as socioeconomic proxy. Disorders of refraction and accommodation were most prevalent, followed by infectious and inflammatory diseases. Potentially preventable and treatable conditions, including amblyopia and strabismus, infectious and inflammatory disease, and diabetic complications, affected up to 22% of those with vision disorders. This study represents the first use of VEHSS measures in a universally insured, socioeconomically diverse population. Identification of potentially treatable or preventable conditions indicates significant opportunity to mitigate the burden of eye and vision disorders in the Military Health System.

К ВОПРОСУ О ВЗАИМОСВЯЗИ АСТЕНОПИЧЕСКИХ ЖАЛОБ И АККОМОДАЦИОННЫХ НАРУШЕНИЙ У ПАЦИЕНТОВ С ГИПЕРМЕТРОПИЕЙ

An analysis was performed of the accommodation, hydrodynamics state of the eye, asthenopic complaints in 58patients (58 eyes) with hyperopia. Accommodation disorders were revealedin the form of constantly redundant tension of accommodation, weakness of accommodation (12,1%), weakness of accommodation (70,7 %), as well as their combination (17,2 %). The accommodation indices in patients with hypermetropydepend on the patients age that should be taken into account during performance a comparative analysis between groups.

Prevalence of vision conditions in children in a very remote Australian community

ABSTRACT Clinical relevance Understanding the prevalence of vision conditions in a population is critical for determining the most appropriate strategies for detecting and correcting eye conditions in a community. This is particularly important in very remote regions where access to vision testing services is limited. Background Although recent studies have provided detailed analyses of the prevalence of vision conditions in Aboriginal and/or Torres Strait Islander children in urban and regional areas of Australia, there is a paucity of research examining vision conditions in children in remote regions. Importantly, a significant proportion of the population in remote and very remote regions identify as Aboriginal and/or Torres Strait Islander people. Methods Comprehensive eye examinations were provided to 193 primary school children in a very remote Australian region. Ninety eight percent of children identified as Aboriginal and/or Torres Strait Islander. The eye examination included measures of visual acuity, cycloplegic autorefraction, binocular vision and accommodative function, ocular health and colour vision. Previous history of eye examinations and refractive correction were assessed through parental questionnaire. Results Although the average unaided vision in the population was good (mean: 0.02 ± 0.13 logMAR) and the prevalence of reduced unaided visual acuity (>0.3 logMAR in either eye) was low (4%), vision conditions were detected in 32% of children. The most common conditions were clinically significant refractive errors (18% of children) and binocular vision or accommodative disorders (16%). Of the total population of children tested, 10% had previously had an eye examination, and 2% were reported to have previously been prescribed spectacles. Conclusions In this population of children in a very remote Australian region, up to 1 in 3 children had a vision condition, with many of these conditions being uncorrected and undetected. These findings highlight the important need for additional resources to be made available to very remote communities for the detection and correction of vision conditions in childhood.