Eye Pathology Research Articles

The assessment of lacrimal film condition in patients with dry eye syndrome during therapy

To evaluate the efficiency of modern imaging methods of meibomian gland ducts and determine the tear film break-up time (TFBUT) during therapy in patients with the secondary dry eye syndrome (SDES) of allergic etiology.Material and methods. 66 patients aged 38.0 ± 1.5 with SDES after allergic conjunctivitis were examined. The patients were divided into 2 groups depending on the therapy administered. The main group (n = 33) received Oftalron as tear replacement therapy for 20 days, 2 drops, 2 times a day. The patients of the comparison group (n = 33) used Super Optic HydroBalance for 20 days, 2 drops 2 times a day. The control group consisted of 25 healthy subjects without eye pathology. All subjects underwent Schirmer’s tests I and II, as well as TFBUT and meibography on an automatic refractokeratometer HRK-9000A (Huvitz, Korea).Results. In both SDES groups, a significant decrease of the OSDI (Ocular Surface Disease Index) in the treatment process was observed (p ≤ 0.05), which corresponded to low intensity of SDES symptoms. In both groups morphofunctional changes of meibomian glands of 1 and 2 stages prevailed. The most significant dynamics was observed in TFBUT results, they were significantly lower in comparison with the similar indexes in the patients of the control group.Conclusion. Specific modes of autorefractokeratometer HRK-9000A allow receiving objective information about the condition of the tear film and high-quality imaging of meibomian glands, which allow expanding possibilities of complex diagnostics of various forms of DES.

Ecological human health risk in aluminum producing areas of Baikal region

The 2017 list of Russian cities with the highest level of air pollution included 21 cities, 7 of which (30%) are located in the Irkutsk region. Among them are large industrial centers of non-ferrous metallurgy - Shelekhov and Bratsk. The purpose of the article is to assess the health risk for the population living in the aluminum producing areas (Shelekhov, Irkutsk region). The health risk was assessed on the basis of G 2.1.10.1920-04 using modern sanitary and hygienic standards. Air quality in 2007-2017 and load on the urban population inhaling polluted air (inhalation route) were determined. Two groups of hazardous effects were identified. Carcinogenic and non-carcinogenic risks were distinguished. Individual inhalation risks were calculated and hazardous substances were identified. The total carcinogenic risk exceeds an acceptable level and is mainly due to inhalation of formaldehyde and chromium (46.7% and 52.3%, respectively). The chronic non-carcinogenic risk is due to the suspended substances, formaldehyde and benzopyrene inhalation. The non-cancerogenic effect of air on the respiratory organs, the immune system and eye pathology is crucial. The article suggests measures (implementation of advanced production technologies, reconstruction of heating systems, etc.) to prevent hazardous risks.

Role of Rho kinase pathway in diabetic retinopathy: from a diabetic rat model to human eye pathology

AbstractDiabetic macular oedema is the main cause of visual loss in diabetic retinopathy, particularly in type 2 diabetic patients. The pathogenic mechanisms are not fully elucidated. Rho/Rock1 pathway is activated in diabetes and is responsible for cellular contraction. ROCK1 activation induces actin cytoskeleton remodeling. We hypothesized that Rho/Rock1 diabetes‐induced activation could contribute to cytoskeleton remodelling especially in retinal vessels subsequently altering retinal perfusion.MethodsWe used 12 months old Goto‐Kakizaki (GK) type 2 diabetic rats. Rho/Rhock1 pathway activation effects on retinal vasculature was analysed and ROCK inhibition by Fasudil administered into the vitreous was tested in rats in vivo on vascular perfusion.ResultsIn diabetic rats, activation of ROCK‐1 induces focal vascular constrictions, endoluminal blebbing and subsequent retinal hypoxia. Intraocular injection of fasudil, significantly reduces retinal hypoxia. Diabetes‐induced cell blebbing may contribute to ischemic maculopathy and represent an intervention target.

Evidence-based Clinical Practice Guidelines for the Periodic Eye Exam in Children Aged 0 to 5 Years in Canada

Vision screening performed by primary healthcare providers during routine well-baby/child visits and scheduled vaccinations is an essential part of the detection of ocular disease. However, this early detection potential is limited and a full oculovisual assessment is also recommended prior to the child entering the school system. If amblyopia, strabismus or other eye pathology is detected or suspected that is beyond the scope of the eye care professional examining the patient, a referral to the appropriate specialist can be made, allowing treatment to be initiated in a timely fashion.

Evidence-based clinical practice guidelines for the periodic eye examination in children aged 0–5 years in Canada

BackgroundAs eye disease before age 5 years is common, some form of vision screening should be performed on children before attending primary school. However, the lack of consistent national recommendations creates confusion for patients, eye care professionals, and governments alike. MethodsThe objective of this document is to provide guidance on the recommended timing, intervals, and types of ocular assessments for healthy children aged 0–5 years. A literature search yielded 403 articles. A multidisciplinary expert committee (comprising 2 optometrists, a comprehensive ophthalmologist, a pediatric ophthalmologist, a family physician, and a pediatrician) independently determined those articles deemed to be key to the clinical question. Articles that were gradable (n = 16) were then submitted for independent critical appraisal by an external review group, which provided a Grading of Recommendations Assessment, Development and Evaluation profile of the reviewed articles to use for assigning a grade of evidence. RecommendationsIn addition to routine screening by a primary health care professional, a comprehensive eye examination by an individual with the expertise to detect risk factors for amblyopia—such as an ophthalmologist or optometrist—is required in early childhood. The findings support the importance of early detection of amblyopia before 36 months and no later than 48 months of age via screening with at least 1 comprehensive eye examination before age 5 years. ConclusionsVision screening performed by primary health care providers during routine well-baby/child visits and scheduled vaccinations is an essential part of the detection of ocular disease. However, this early detection potential is limited, and a full oculovisual assessment is also recommended before the child entering the school system. If amblyopia, strabismus, or other eye pathology is detected or suspected that is beyond the scope of the eye care professional examining the patient, a referral to the appropriate specialist can be made, allowing treatment to be initiated in a timely fashion.

Динамика распространенности глаукомы в Киргизской Республике

This article discusses the dynamics of glaucoma prevalence in the Kyrgyz Republic. At present glaucoma is one of the pressing problems of modern health care, as it occupies one of the leading places among the causes of irreversible loss of vision. According to WHO glaucoma accounts for up to 5% of all eye pathology. By 2020, the number of patients will increase to 5.9 million and 5.3 million will lose sight due to primary glaucoma. The proportion of primary glaucoma among the causes of primary disability has been stable at a fairly high level from 20 to 28% over the years. The problem of glaucoma control requires improvement of the system of organization of early detection and dispensary observation of patients, which will contribute to control of the level of morbidity and quality of medical care. The article used data from the Republican Medical and Information Center of the Ministry of Health of the Kyrgyz Republic from 2014 to 2018. On the basis of a comprehensive analysis, the authors identified trends in the incidence of diseases of the eye and its appendages, glaucoma among adults, adolescents and children of the Kyrgyz Republic. The incidence of diseases of the eye and its appendages, glaucoma among adults, teenagers and children in dynamics from 2014 to 2018 has been studied. The share of glaucoma in the total number of diseases of the eye and its appendages among adults, teenagers and children is considered. Analysis of the dynamics of disease prevalence of the eye, its appendages, glaucoma, both among adults and teenagers, and among children under 14 years of age showed an increase in the indicator in 2015, 2017 and 2018. The proportion of glaucoma from the total morbidity of the eye and its appendages among adults and adolescents in the years under study averaged 6.4%, among children under 14 — 0.2%. It is necessary to strengthen measures for early detection, dispensarization of glaucoma patients, as well as to carry out information work among the population.

A case of a misdiagnosis of myasthenia in a patient with undifferentiated connective tissue dysplasia

We present a clinical case of a wrong diagnosis of myasthenia in a patient with incomplete ptosis slowly progressing for 5 years, which, by its isolation and asymmetry, imitated ocular symptomatology in myasthenia. The clinical picture was not consistent with the diagnostic criteria for myasthenia. Moreover, other pathology according to laboratory and instrumental studies was absent. There was observed a combination of signs of connective tissue dysplasia in the heart in the form of valve syndrome, skeletal abnormalities, eye pathology syndrome, which made it possible to diagnose the syndrome of undiff erentiated connective tissue dysplasia. Diffi culties in the diff erential diagnosis were polysystemic lesions, the absence of pathognomonic tests for the detection of connective tissue dysplasia, and features of a diff erential diagnosis with ocular myasthenia gravis.

Optical coherence tomography in the diagnosis and follow-up of eye diseases in childhood - a review

After its development approximately 20 years ago, optical coherence tomography (OCT) has taken an important part in the scientific and clinical work of the ophthalmologist and continues to develop. Using OCT technology in every day practice helps the eye doctors to make clinical diagnoses and follow-up of socially significant diseases like glaucoma, degenerative retinal diseases, and pathology of the macula and optic nerve head, which could be responsible for irreversible decrease or loss of central and/or peripheral vision. Because of the above-mentioned, we aimed to summarize the diagnostic and follow-up possibilities of OCT as an imaging technique for childhood eye diseases. Since this technology was initially developed to be used in adults, its use in children is limited to some extent. This could be explained basically with the inapplicability of stationary OCT devices in all children and the absence of normative database for those under 18 years of age. During the last decade, specially developed portable devices for children have been developed. By their use investigating and diagnosing of eye pathology is possible in very early age, and this allows subsequent adequate therapy and prevents from a life with disability.

Аномалия Петерса: клиника, диагностика и результаты хирургического лечения

The Peters’s Anomaly (PA) is an infrequent congenital anomaly of a cornea and anterior segment of eye. The rarity of this pathology and difficulty bound to inspection of newborns generate a situation when more or less certain clinical approaches to maintaining this anomaly remain obscure for most of children’s ophthalmologists. Purpose. To study clinical implications and to estimate results of surgical treatment in children with PA. Material and methods. Under observation from 1996 for 2016 on examination and treatment there were 51 children with the PA different forms, aged from 3 months up to 10 years: 1 group – mesodermal – 20 people (37%), 2 – group the ectodermal 31 child (63%). Surgical treatment – penetrating keratoplasty (PKP) was carried out at 43 patients (69 eyes) aged from 8 up to 36 months. At other children (8 people) surgery was contraindicative because of serious somatic and eye pathology. Clinical-functional and ophthalmologic examination at all was conducted in the conditions of medication sleep. PKP carried out by a traditional technique, as donor material used a fresh cadaver cornea with prescription of a fence from death moment before operation no more than 48 hours. The biological result of surgery was estimated by a moment method (or Kaplana-Maier’s method) by means of which calculated so-called survival of a graft. Functional result – at children to 3-x years estimated approximately: on tracking of the child toys from a certain distance and method of a preferable look, at children of advanced age according to Sivtsev-Golovin’s table. Postoperative observation proceeded from 3 months to 15 years. The corneal disks removed during surgery were exposed to a histological research. Results. Within the first year after PKP a transparence of the replaced cornea remained in 1 group on 29 eyes (90%), in 2 group – at 21 patients of 26 eyes (67%). In 2 years after surgery the transparent donor cornea at children in 1 group remained at 17 patients (20 eyes, 62%); in – the second at 15 patients of 18 eyes (54%). In 5 years after surgery – at patients of 1 group a transparence of the replaced donor tissue was kept by 17 eyes (53%), in the second only 12 of 31 executed surgery (39%). In 10 years transparent were 53% and 31% of corneas, respectively. In 15 years after surgery a transparence was kept in 1 group of 15 eyes (46%), in 2 – on 9 (22%). Visual acuity (0,3 and above) was observed at 8 of 13 children (61%) after surgery about one year at children of advanced age only in 27% of cases, even at tr ansparent engraftment of a graft. Conclusion. The keratoplasty at PA at children of early age is the only chance to save the child from a blindness and disability on vision.

Teleophthalmology through handheld mobile devices: a pilot study in rural Nepal.

To compare screening referral recommendations made by remotely located ophthalmic technicians with those of an ophthalmologist examining digital photos obtained by a portable ophthalmic camera system powered by an iOS handheld mobile device (iPod Touch). Dilated screening eye exams were performed by ophthalmic technicians in four remote districts of Nepal. Anterior and posterior segment photographs captured with a Paxos Scope ophthalmic camera system attached to an iPod Touch 6th generation device were uploaded to a secure cloud database for review by an ophthalmologist in Kathmandu. The ophthalmic technicians' referral decisions based on slit-lamp exam were compared to the ophthalmologist's recommendation based on the transmitted images. Using the transmitted images, the ophthalmologist recommended referral for an additional 20% of the 346 total subjects screened who would not have been referred by the ophthalmic technician. Of those subjects, 34% were referred to the retina clinic. Conversely, among the 101 patients referred by the technician, the ophthalmologist concurred with the appropriateness of referral in more than 97% of cases but thought eight (2.8%) of those patients had variants of normal eye pathology. An ophthalmologist who reviewed data and photos gathered with the mobile device teleophthalmology system identified a significant number of patients whose need for referral was not identified by the screening technician. Posterior segment pathology was most frequently found by the remote reader and not by the technician performing dilated slit lamp examinations. These results are promising for further clinical implementation of handheld mobile devices as tools for teleophthalmic screening in resource-limited settings.

An Overview of Herbal Traditional Eye Care Practices and the Development of Eye Health Promotion Strategies in Cameroon

Herbal plants have played an important role traditional medicine therapy of multiple human illnesses since the existence of man in many parts of the globe .The most common eye diseases include conjunctivitis, cataract, glaucoma, eye allergies, eye inflammation. The problem of adverse drug effects of modern drugs, has led to the increased use nowadays of herbal remedies in the treatment of eye diseases. The World Health Organization (WHO), defines traditional medicine as, the knowledge, skills and practices based on theories, beliefs, and experiences indigenous to diverse cultures, be it explicable or not that are used in the maintenance of health and the prevention, diagnosis, improvement and the treatment of physical and mental diseases. In the last decade, the use of traditional medicine has gained popularity and has expanded globally. While traditional medicine is used in developing countries for primary health care, it is also being used in developed countries with advanced health care systems. Traditional medicine accounts for up to 60% of health care delivered in Cameroon, while in other African countries traditional medicine is being relied on as a result of cultural and historical beliefs and up to 80 % of the population in Africa use traditional medicine to meet their health care needs. Although, traditional medicine is widely used, issues around policy; safety; efficacy and quality control are still of prime public health concern.
 Traditional eye care practices are believed to be indigenous medicines used by community members for the treatment of eye diseases or ocular problems. This is the most applied form of eye treatment in Africa and other parts of Asia and Latin America. Eye care is a public health concern in Cameroon due to late diagnosis of eye pathology and limited access to medication and affordability of prescription eye glasses. This paper attempts to review the herbal medicine practice as an alternative approach to eye treatment using traditional healing, and the development of eye health promotion strategies in the primary health care system in Cameroon.

Features of the eye pathology in primary hyperparathyroidism

The pathology of vision occurs in various endocrine diseases, but information about the state of the eyes in patients with primary hyperparathyroidism (PHPT) has been limited yet. Large systematic studies on this problem are absent, mainly the data of foreign literature are based on descriptions of several clinical cases that report about non-specific changes of eyes in people with significant hypercalcemia. The most common manifestations of hyperparathyroid ophthalmopathy are the cornea and conjunctiva calcification, disfunction of the eye muscles. Taking into account the prevalence of mild PHPT caused by early diagnosis and timely pathogenetic treatment of the disease, nowadays these ophthalmic disorders are rare. However, specific eye pathology in this category of patients requires detailed study and further research.

ReLayer: a Free, Online Tool for Extracting Retinal Thickness From Cross-Platform OCT Images.

PurposeTo describe and evaluate a free, online tool for automatically segmenting optical coherence tomography (OCT) images from different devices and computing summary measures such as retinal thickness.MethodsReLayer (https://relayer.online) is an online platform to which OCT scan images can be uploaded and analyzed. Results can be downloaded as plaintext (.csv) files. The segmentation method includes a novel, one-dimensional active contour model, designed to locate the inner limiting membrane, inner/outer segment, and retinal pigment epithelium. The method, designed for B-scans from Heidelberg Engineering Spectralis, was adapted for Topcon 3D OCT-2000 and OptoVue AngioVue. The method was applied to scans from healthy and pathological eyes, and was validated against segmentation by the manufacturers, the IOWA Reference Algorithms, and manual segmentation.ResultsSegmentation of a B-scan took ≤1 second. In healthy eyes, mean difference in retinal thickness from ReLayer and the reference standard was below the resolution of the Spectralis and 3D OCT-2000, and slightly above the resolution of the AngioVue. In pathological eyes, ReLayer performed similarly to IOWA (P = 0.97) and better than Spectralis (P < 0.001).ConclusionsA free online platform (ReLayer) is capable of segmenting OCT scans with similar speed, accuracy, and reliability as the other tested algorithms, but offers greater accessibility. ReLayer could represent a valuable tool for researchers requiring the full segmentation, often not made available by commercial software.Translational RelevanceA free online platform (ReLayer) provides free, accessible segmentation of OCT images: data often not available via existing commercial software.

Point-of-care ultrasound for the evaluation of non-traumatic visual disturbances in the emergency department: The VIGMO protocol

ObjectivesTo establish a standardized approach for the rapid and accurate identification of non-traumatic, ophthalmologic pathology in patients with eye complaints in the emergency department. MethodsIn this detailed protocol we offer an easy, reproducible method for the use of ocular point-of-care ultrasound (POCUS) in helping practitioners identify and distinguish between common eye pathology encountered in the emergency setting: retinal detachment, vitreous detachment, vitreous hemorrhage, optic nerve pathology, and syneresis. ConclusionsThis protocol can help identify patients that may need urgent ophthalmology consultation those that can follow-up on an outpatient, and those that may need additional emergent testing.

Multi-scale and -contrast sensorless adaptive optics optical coherence tomography.

The roles of the retinal microvasculature and the retinal pigment epithelium (RPE) in maintaining the health and metabolic activity of the retina lend great clinical value to their high-resolution visualization. By integrating polarization diversity detection (PDD) into multi-scale and -contrast sensorless adaptive optics optical coherence tomography (MSC-SAO-OCT), we have developed a novel multi-contrast SAO OCT system for imaging pigment in the RPE as well as flow in the retinal capillaries using OCT angiography (OCTA). Aberration correction was performed based on the image quality using transmissive deformable optical elements. MSC-SAO-OCTA imaging was performed at multiple fields-of-view (FOVs) with adjustable numerical aperture (NA). Retinal flow and RPE structural images for in vivo healthy and pathological human posterior eyes were demonstrated to show clinical feasibility of the system. High-resolution imaging of retinal vasculature at both large and small FOVs, as well as characterization of RPE topology and deformation, enables more sophisticated and concise investigation of retinal pathologies for in vivo human imaging. MSC imaging may permit detection and analysis of even subtle deformations in the RPE layer using a single instrument.

Мodern Approaches to the Treatment and Prevention of Recurrent of Ophthalmic Herpes. Review

The review focuses on modern treatment aspects and prevention of ophthalmic herpes.The generalized experience of the clinical nucleoside administration, the basic antiviral drugs in the treatment of this pathology, is presented in detail. Information about indications, side effects and various schemes for their systemic and local application is provided. Questions on the duration of nucleoside administration in various clinical forms of eye herpes are considered. A meta-analysis of the comparative therapeutic nucleoside efficacy based on the results of more than 100 placebo-controlled randomized trials is presented. Special attention is paid to the rare but severe eye pathology, the acute retinal necrosis. Also data on the indications and contraindications of corticosteroids and on the current view of immunotherapy of ophthalmic herpes is presented. The question of the modern approach to the disease prevention recurrences is considered in detail, particularly, the results of the nucleoside administration have a high level of evidence, and, herpetic vaccines in the rehabilitation of patients with herpes infection are not widely used due to the lack of reliable methods for evaluating the efficacy. The information on the search for new effective drugs that have a targeted effect on certain patient cell receptors that can inhibit the penetration and spread of the herpes virus that can cause a controlled immune response is provided. Expanding the arsenal of effective and safe antiviral therapy will definitely optimize the treatment of ophthalmic herpes and prevent the occurrence of its recurrence and severe outcomes.

Diabetic Retinopathy Assessment Variability Among Eye Care Providers in an Urban Teleophthalmology Program.

Background: Teleophthalmology is an evidence-based method for diabetic eye screening. It is unclear whether the type of eye care provider performing teleophthalmology interpretation produces significant variability.Introduction: We assessed grading variability between an optometrist, general ophthalmologist, and retinal specialist using images from an urban, diabetic retinopathy teleophthalmology program.Methods: Three readers evaluated digital retinal images in 100 cases (178 eyes from 90 patients with type 2 diabetes). Fisher's exact test, percent agreement, and the observed proportion of positive (Ppos) or negative agreement (Pneg) were used to assess variability.Results: Among cases deemed gradable by all three readers (n = 65), there was substantial agreement on absence of any retinopathy (88% ± 4.6%, Pneg = 0.91–0.95), presence of moderate nonproliferative or worse retinopathy (87% ± 3.9%, Ppos = 0.67–1.00), and presence of macular edema (99% ± 0.9%, Ppos = 0.67–1.00). There was limited agreement regarding presence of referable nondiabetic eye pathology (61% ± 11%, Ppos = 0.21–0.59) and early, nonroutine referral for a follow-up clinical eye exam (66% ± 8.1%, Ppos = 0.19–0.54). Among all cases (n = 100), there was acceptable agreement regarding which had gradable images (77% ± 5.0%, Ppos = 0.50–0.90).Discussion: Inclusion of multiple types of eye care providers as teleophthalmology readers is unlikely to produce significant variability in the assessment of diabetic retinopathy among high-quality images. Greater variability was found regarding image gradability, nondiabetic eye pathology, and recommended clinical referral times.Conclusions: Our results suggest that more extensive training and uniform referral standards are needed to improve consensus on image gradability, referable nondiabetic eye pathology, and recommended clinical referral times.

Neutrophil Extracellular Traps Confine Pseudomonas aeruginosa Ocular Biofilms and Restrict Brain Invasion

Bacterial biofilm infections are difficult to eradicate because of antibiotic insusceptibility and high recurrence rates. Biofilm formation by Pseudomonas aeruginosa, a leading cause of bacterial keratitis, is facilitated by the bacterial Psl exopolysaccharide and associated with heightened virulence. Using intravital microscopy, we observed that neutrophilic recruitment to corneal infections limits P.aeruginosa biofilms to the outer eye surface, preventing bacterial dissemination. Neutrophils moved to the base of forming biofilms, where they underwent neutrophil extracellular trap formation (NETosis) in response to high expression of the bacterial type-3 secretion system (T3SS). NETs formed a barrier "dead zone," confining bacteria to the external corneal environment and inhibiting bacterial dissemination into the brain. Once formed, ocular biofilms were resistant toantibiotics and neutrophil killing, advancing eye pathology. However, blocking both Psl and T3SS together with antibiotic treatment broke down the biofilm and reversed keratitis, suggesting future therapeutic strategies for this intractable infection.

Retinal abiotrophy in mitochondrial pathology: NARP sindrome (a clinical case)

Purpose: to present a clinical case of retinal abiotrophy in mitochondrial pathology (NARP syndrome) caused by the mutation m.8993T&gt;G in the ATPase gene type 6 in order to improve the diagnosis of hereditary abiotrophies. Material and methods. The results of a clinical molecular genetic examination of the patient’s family, undertaken in order to clarify the diagnosis and determine the genetic risk, are presented. The family was found to have an isolated pathology of the eye. Results. DNA studies by MLPA method and the analysis of clinical data in the family revealed a hereditary syndromic pathology which caused changes in the eyes. The inheritance type was found to be maternal. Conclusion. NARP syndrome is a syndrome with the maternal type of inheritance in which retinal abiotrophy is primarily associated with the mutation m.8993T&gt;G mtDNA and can be considered as the main diagnostic feature among other clinical manifestations. The case demonstrates the difficulties of diagnosing hereditary syndromes accompanied by eye pathology.

Blood glucose level impact on biometric parameters, refraction and intraocular pressure in patients with subcompensated insulin-requiring type II diabetes

Purpose. To study the relationship of biometric parameters, visual acuity, eye refraction and intraocular pressure (IOP) with blood glucose levels and glycated hemoglobin (HbA1c) in patients with subcompensated insulin-requiring type II diabetes mellitus. Material and methods. Ophthalmic monitoring lasted 3 years, the experience of insulin therapy — 6 years. 32 patients (27 women and 5 men) with insulin-requiring diabetes mellitus and no severe general diabetic complications or concomitant eye pathology were monitored for 3 years. The patients’ average age was 60.4 ± 5.3 years; average weight 94.3 ± 16.5 kg; average height 163.4 cm; average BMI (body mass index) was 29.93 kg/m2, all received insulin treatment for 6 years. Patients determined the level of blood glucose themselves on a daily basis using individual “Accu-Check” and/or “OneTouch select” glucometers, supplemented by endocrinologist checks on scheduled examinations once a month. The level of glycated hemoglobin (HbA1c) was determined once every 3–6 months. The 3-year ophthalmic monitoring involved both eyes and included biomicroscopy, autorefractometry, pneumotonometry, measurement of the anterior-posterior axis, the depth of the anterior chamber and lens thickness; pachymetry of the cornea in the central optical zone, and ophthalmoscopy. Visometry was performed according to ETDRS (Early Treatment Diabetic Retinopathy Study Research Group) requirements. Results. The impact of blood glucose level on visual acuity (Spearman R = 0.18/-0.23, t (N-2) = 1.07/-1.34, p = 0.1) is higher than that of HbA1c (Spearman R = 0.07/-0.15, t (N-2) = 0.4/-0.8, p = 0.65) The higher the glucose level, the lower the depth of the anterior chamber and the shorter the APA. In contrast, the higher the level of HbA1c, the thicker the cornea in the central optical zone. Both the glucose and the HbA1c levels reveal a similar positive correlations with IOP. A refraction shift toward myopia from 42 % to 55 % was shown to correlate to HbA1c, and a corresponding reduction of hyperopia share was revealed. Conclusions. In patients with subcompensated insulin-requiring diabetes mellitus type II, biometric parameters, refraction and intraocular pressure are determined by changes in the level of blood glycemia.