Ophthalmological Care Research Articles

Forecasting Retirement in Pediatric Ophthalmology

This cross-sectional study uses a forecasting model to assess the potential loss of pediatric ophthalmology care in the US due to potential ophthalmologist retirement.

Chronic eyelid and ocular itch

Chronic eyelid and ocular itch affect many patients seeking dermatologic or ophthalmologic care and have a high burden on patient quality of life. Clinicians should consider the broad range of possible diagnoses when approaching the patient with itch of the eyes or eyelids lasting more than 6 weeks. Allergic conjunctivitis and allergic contact dermatitis are the most common causes of chronic itch of the eyes and eyelids, respectively. Other diagnoses to consider include atopic dermatitis, xerosis, neurogenic itch, dry eye syndrome, seborrheic dermatitis, blepharitis, rosacea, lichen simplex chronicus, and papulosquamous disorders. If no organic cause can be elucidated, diagnoses of psychogenic pruritus or chronic pruritus of unknown origin may be considered. Herein, we discuss the possible etiologies of chronic eyelid and ocular itch inclusive of clinical presentation, diagnostic considerations, and current therapies.

Artificial intelligence enabled smart digital eye wearables.

Smart eyewear is a head-worn wearable device that is evolving as the next phase of ubiquitous wearables. Although their applications in healthcare are being explored, they have the potential to revolutionize teleophthalmology care. This review highlights their applications in ophthalmology care and discusses future scope. Smart eyewear equips advanced sensors, optical displays, and processing capabilities in a wearable form factor. Rapid technological developments and the integration of artificial intelligence are expanding their reach from consumer space to healthcare applications. This review systematically presents their applications in treating and managing eye-related conditions. This includes remote assessments, real-time monitoring, telehealth consultations, and the facilitation of personalized interventions. They also serve as low-vision assistive devices to help visually impaired, and can aid physicians with operational and surgical tasks. Wearables such as smart eyewear collects rich, continuous, objective, individual-specific data, which is difficult to obtain in a clinical setting. By leveraging sophisticated data processing and artificial intelligence based algorithms, these data can identify at-risk patients, recognize behavioral patterns, and make timely interventions. They promise cost-effective and personalized treatment for vision impairments in an effort to mitigate the global burden of eye-related conditions and aging.

Idiopathic Epiretinal Membranes - Pathophysiology, Classifications and OCT-Biomarkers.

Epiretinal membranes (ERMs) are a common finding in patients with increasing age. Diagnosis and treatment of ERMs have changed dramatically in recent years due to technological advances in ophthalmological care. In recent years, tomographic imaging has allowed for accurate visualization of ERMs and contributed to the growing understanding of the pathophysiology of this condition. The literature review conducted here summarizes recent innovations in diagnosis, classification, and treatment of idiopathic ERMs and specifically addresses novel optical coherence tomography (OCT) biomarkers that allow for the generation of prognoses regarding the clinical postoperative outcome.

Current Challenges and Solution of Ophthalmology during Covid-19: An evidence-based practice

Background: The coronavirus 2019, also known as SARS-CoV-2, is highly contagious and spreads easily through respiratory droplets when an infected person coughs or sneezes. In December 2019 Wuhan China, the virus was first detected and has become a global pandemic. Aim: To maintain an evidence-based ophthalmology practice during the Covid-19 pandemic, some strategies and guidelines that may be considered and to adapt their practices to the challenges presented by the Covid-19 pandemic while still maintaining evidence-based care. Methods: This narrative review study was conducted in ophthalmology department of Akbar Niazi Teaching Hospital (ANTH), Islamabad between January and March 2023. Some guidelines during Covid-19 outbreak were discussed. Results: Identifying and addressing challenges in different care settings is important for maintaining high-quality ophthalmology care during the Covid-19. Minimizing cross-infection of Covid-19 is essential in healthcare settings to protect both healthcare workers and patients. Stringent infection control measures with personal protective equipment (PPE) and routine cleaning of "high-touch" surfaces, are important strategies to reduce the risk of transmission. Implementing a stringent dual screening and triaging process is a crucial step for outpatient care during the Covid-19 pandemic. This helps to identify high-risk patients and provide appropriate care while minimizing the risk of transmission to other patients and healthcare workers. Separating inpatient and outpatient care is another important strategy to minimize interactions and reduce the risk of transmission of Covid-19. Planning logistics and manpower is critical during the Covid-19 pandemic to ensure that healthcare facilities have the necessary resources and staff to meet the needs of patients. The practical implication of this review was to develop strategies for safe routine eye care and surgery to maintain practice. Conclusion: The measures implemented in response to the Covid-19 in ophthalmology clinics can serve as a guide for healthcare facilities facing similar disease outbreaks in the future. Keywords: Challenges; Evidence-based practice; Ophthalmology; SARS-CoV-2.

Bilateral acute angle closure attack precipitated with dengue fever

Dengue is known to cause varied ocular problems from mild-to-severe sight threatening. We present the case of a 63-year-old female patient with bilateral shallow anterior chamber and acute angle closure attack precipitated during the convalescent phase of dengue infection. She arrived at the emergency department at midnight with a history of vomiting, headache, weakness, and pain in the left eye (LE). Her diagnosis of dengue fever was supported by specific serological testing. On ocular examination, the anterior chamber of both eyes was noticeably shallow and her LE felt stony hard on digital palpation. Intravenous mannitol 300 mL over 45 min were given stat followed by topical medications. In the morning, intraocular pressure measured was 10 mmHg (right eye [RE]) and 26 mmHg (LE). After thorough examination, she was diagnosed with occludable angle in RE and angle closure in LE after gonioscopy. Neodymium-doped Yttrium Aluminum Garnet laser peripheral iridotomy was done in both eyes. She was relieved of symptoms. The varied spectrum of possible ocular symptoms should prompt the ophthalmologist to suspect the potential involvement of eye in dengue fever. Detailed history taking is of utmost importance in early diagnosis of some rare presentation of dengue-related ophthalmic involvement. Increased awareness of dengue-related ophthalmic complications among clinicians involved in the care of patients with dengue would facilitate prompt ophthalmologic assessment and emergency medical care.

The dynamics of the volume and structure of demand of the population for high-tech ophthalmological care

The dynamics of the volume and structure of demand of the population for high-tech ophthalmological care

Эффективность консультативной помощи при лечении и обследовании сложных офтальмологических пациентов с помощью телемедицины

Purpose. Evaluation of the first experience of implementing telemedicine technologies by the national medical research center in medical organizations in the Far Eastern Federal District (FEFD). Material and methods. The analysis of organizational and technical difficulties of creating a stable system of scheduled and unscheduled telecommunication activities between the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of Russia (Branch) and assigned medical organizations of the 3rd level providing ophthalmological care to patients from 8 administrative territories of the FEFD. Results. The Branch established organizational and methodological department, which clarified and eliminated the factors that prevent the implementation of telemedicine consultations / consultations and the transmission of knowledge for ophthalmologists of medical organizations of the 3rd level; a set of organizational measures was taken to register the data of medical organizations in the Federal Register of Medical Organizations, in the Unified State Information System in the field of healthcare; the equipment necessary for communication was purchased and technically prepared; provided methodological assistance in setting up and adjusting equipment in the regions, including field visits; backup connections of several providers are created; an algorithm for preliminary notification of regional ophthalmologists about knowledge transfers was developed; the organizational algorithm for generating a request for telemedicine consultations was tested. For 2019–2022 the Branch conducted: 41 knowledge broadcasts (in 2019 – 24, in 2020 – 8, in 2021 – 8, in 2022 – 1), 947 telemedicine consultations (in 2019 – 180, in 2020 – 185, in 2021 – 277, in 2022 – 305) to patients living mainly in the territory of the FEFD. Conclusions. The introduction of a system of periodic telecommunication events between the Branch and assigned medical organizations of the 3rd level into the daily clinical practice of ophthalmologists of the FEFD after the elimination of organizational and technical difficulties showed a high demand, allowing consultations on patient management in accordance with modern standards for the provision of ophthalmological care, as well as receiving ophthalmologists of the FEFD new and timely knowledges. Keywords: telemedicine, teleophthalmology, Far Eastern Federal District, translation of knowledge, telemedicine consultation

CDC consultations related to ophthalmologic practices and settings, 2016–2021

Background: Healthcare activities that include instrumentation or manipulation of mucosal tissue or normally sterile sites, such as the eye and its associated structures, place patients at risk of infectious and other complications. We reviewed queries to the CDC Prevention and Response Branch that were focused on ophthalmologic procedures and settings to examine opportunities to improve infection prevention and control (IPC) practices in these settings. Methods: We reviewed internal CDC consultation records received from January 1, 2016, through December 31, 2021, to identify those involving ophthalmologic procedures or settings. Consultations were reviewed to determine setting type, number of patients affected, organisms identified, nature of infection control breaches, and whether medical products were implicated. Descriptive statistics were calculated. Results: We identified 24 consultations among 19 states and US territories. Of these, 21 (87.5%) involved outpatient settings, of which 9 (43%) were ambulatory surgery centers. Consultations included the following non–mutually exclusive categories. There were 18 adverse postsurgical events (75%), such as mycobacterial infection after laser surgery and toxic anterior segment syndrome following cataract surgery (n = 5). There were 11 infections following ophthalmologic clinical care (46%), such as epidemic keratoconjunctivitis due to adenovirus 8. There were 8 suspected medication-related events (33%) including contamination of ophthalmic medication when manufactured or compounded offsite. There were 8 medical-device reprocessing concerns (33%) including inappropriate high-level disinfection. There were 8 instances of improper environmental cleaning and disinfection (33%), for example, during an adenovirus outbreak. There were 3 cases of potential mishandling of medications onsite (12.5%), such as multiuse eye drops. Also, 3 events (12.5%) were associated with potentially contaminated donor tissue, such as corneas for transplantation. When a consultation included identification of a pathogen (n = 11), organisms included bacteria (n = 7, 64%), viruses (n = 2, 18%), and fungi (n = 3, 27%). In total, 202 patients had confirmed ophthalmologic infections or adverse events. Conclusions: Based on our review of recent outbreaks, healthcare personnel in ophthalmologic settings may have deficits in training related to instrument reprocessing and environmental cleaning specific to ophthalmic equipment and settings that can result in harm to patients. These settings could benefit from targeted training to improve IPC practices specific to ophthalmologic examinations and procedures. This review was limited to analysis of investigations that were voluntarily reported to the CDC. A formal surveillance system for adverse outcomes in this setting could clarify the nature and frequency of IPC issues of greatest concern.Disclosures: None

Первые результаты организационной деятельности Хабаровского филиала ФГАУ «НМИЦ «МНТК «Микрохирургия глаза» им. акад. С.Н. Фёдорова» Минздрава России в Дальневосточном регионе в качестве национального медицинского исследовательского центра

Purpose. Assessment of the first results of the organizational and methodological department (OMD) of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (Branch) activities for 2018–2022. Material and methods. OMD was established in the Branch in February 2019. This was necessary to ensure effective interaction with the Level 3 medical organizations assigned to the Branch as a National Medical Research Center (NMRC) located in the Far Eastern Federal District (FEFD). Results. Some of organizational measures were taken to connect to the Unified State Health Information System, a systematic assessment of the level of ophthalmological care in assigned medical organizations was organized, problems of organizational interaction of the NMRC in the FEFD were identified, ways to solve them were outlined, a system of regular telemedicine consultations was established on management of the most complex patients. For 2018– 2022 in total, 40 visits to regions were made, 41 knowledge transfers were conducted, a scientific and educational module «Age-related macular degeneration, dry form» was created, an assessment was made of the effectiveness of the implementation and application of clinical recommendations, including quality assessment criteria for «Ophthalmology» profile in assigned medical organizations. During this period, 947 telemedicine consultations were performed, as a result of which 23.3 % of patients were hospitalized in the Branch in 2019, 73 % of patients in 2020, 86.3 % of patients in 2021 and 90 % of patients in 2022. Established business contacts with the heads of the highest executive authorities of the supervised subjects of the FEFD. Conclusions. As a result of the OMD activities of the Branch from 2018 to 2022 a clear system of organizational and methodological assistance was formed for Level 3 medical organizations located on the territory of the assigned regions of the FEFD. Keywords: national medical research center, organizational and methodological department, Far Eastern Federal District, telemedicine consultation, knowledge transfer

Сравнительный анализ изменения обращаемости в кабинет неотложной помощи ОБУЗ «Офтальмологическая клиническая больница – офтальмологический центр» г. Курска на фоне пандемии коронавирусной инфекции COVID-19

Eye injuries, along with other urgent conditions, are one of the main causes of disability in ophthalmology. The organization of emergency departments in ophthalmic hospitals serves to minimize the time interval between injury and the provision of highly specialized care. Against the background of the COVID-19 pandemic, certain changes have occurred both in the structure of morbidity and in the provision of emergency assistance to the population. The purpose of the work: to study the epidemiology of appeals related to emergency ophthalmological care, according to the emergency department of the OBZ «Ophthalmological Clinical Hospital – Ophthalmological Center» in Kursk in 2012 and 2021 and compare the indicators. Material and methods. As part of the work of the emergency department of eye microsurgery, a retrospective quantitative analysis of appeals with damage to the visual organ and other pathologies was carried out. There is a significant, more than 100-fold increase in the volume of treatment of patients with inflammatory diseases. This is partly due to the transformation of a number of medical institutions into institutions for the treatment of coronavirus infection. COVID-19 infection not only causes inflammatory diseases of various organs and systems, but also contributes to the manifestation of all chronically occurring pathologies. Keywords: emergency care, COVID-19 pandemic, inflammatory diseases.

Changes in neonatal care : Implications for ophthalmological care

Preterm infants are at risk of characteristic, sometimes life-threatening diseases and development of deficits related to immaturity. In the field of ophthalmology, retinopathy of prematurity (ROP) and vision impairment reflect structural and functional disturbances in this large group of patients. In high income countries, more and more very immature preterm infants survive into adolescence and adulthood. To characterize the impact of an increasing number of surviving individuals born preterm on the provision of ophthalmological care in Germany. A literature search and analysis of key figures and quality indicators published in national health registers were carried out. Currently, about 60,000 preterm infants are born in Germany every year. Of these, approximately 3600 extremely immature preterm infants with agestational age < 28weeks are treated with a curative approach on neonatal units. The survival rate is around 80%. Arise in the proportion of infants suffering from severe ROP has not been observed in recent years in Germany. The incidences of other structural and functional visual impairments vary between 3% and 25% in high income countries. The incidence of ROP apparently has not increased in Germany. However, specific peculiarities of the structure and function of the visual system of individuals born preterm have to be taken into account. Approximately 70,000 outpatient check-ups of infants and toddlers, who require both, ophthalmological and developmental neurological expertise, are estimated for Germany each year.

Late sequelae of retinopathy of prematurity in infancy

Retinopathy of prematurity (ROP) is one of the most frequent causes of severe visual impairment or blindness in childhood and can lead to severe late complications in children even after the initial disease has resolved. The present study summarizes possible late effects in childhood after treated and untreated ROP. Aspecial focus is on the development of myopia, retinal detachment, as well as neurological and pulmonary development after anti-vascular endothelial growth factor (VEGF) treatment. This work is based on aselective literature search on late effects in childhood of treated or untreated ROP. Preterm infants have an increased risk of developing high-grade myopia. Interestingly, several studies indicate that the risk of myopia is reduced following anti-VEGF treatment. With anti-VEGF treatment, however, late recurrences after initial response are possible even after several months, making long-term and frequent follow-up examinations essential. Controversy exists regarding the possible negative effects of anti-VEGF treatment on neurological and pulmonary development. After both treated and untreated ROP, rhegmatogenous, tractional or exudative retinal detachment, vitreous hemorrhage, high myopia and strabismus are possible late complications. Children with ahistory of ROP with or without treatment have an increased risk for late ocular sequelae, such as high myopia, retinal detachment, vitreous hemorrhage and strabismus. Aseamless transition from ROP screening to pediatric and ophthalmological follow-up care is therefore essential for timely detection and treatment of possible refractive errors, strabismus, or other amblyogenic changes.

Determining the prevalence of the use of snellen chart to conduct a visual acuity assessment undertaken by primary care practitioners when referring to secondary care ophthalmology services

This article aims to discuss and audit the prevalence of visual acuity assessments performed by primary care practitioners in patients with acute visual concerns, when referring to secondary care ophthalmology services. This audit was undertaken by collection of information through a proforma (Appendix 2) and referral information was taken from across the North East England region via a referral phone. Results shows that less than 50% of referrals included any form of visual acuity assessment, primarily due to lack of access to Snellen charts.

Ophthalmological follow-up of premature children in St. Petersburg

Premature newborns have a high risk of developing visual impairments. This study presents the experience of an organization dispensary ophthalmological observation as a stage of providing medical care to premature children in St. Petersburg and the prospects for its development.&#x0D; AIM: To analyze the effectiveness of the organizational model of dispensary ophthalmological observation of premature children in St. Petersburg for 20202022.&#x0D; MATERIAL AND METHODS: Reporting forms of the activities of interdistrict ophthalmological cabinet and reporting forms of medical and social expertise of Rosstat No. 7D were used.&#x0D; RESULTS: In 2010, a system of specialized ophthalmological care for premature infants at the hospital stage was organized in St. Petersburg (screening and laser treatment of active ROP using telemedicine technologies; surgical treatment of late disease stages). In 2018, for the subsequent dispensary observation of premature children aged up to 3 years, six inter-district ophthalmological cabinets of follow-up were organized. A developed routing scheme for children at risk and with active and cicatricial ROP in St. Petersburg and preliminary results of ROP incidence were presented.&#x0D; CONCLUSION: The activities of specialized inter-district follow-up cabinets primarily ensure continuity between hospital and outpatient services in the dynamic monitoring of children at risk and children with active ROP. In addition, professional competencies allow ophthalmologists to avoid mistakes in diagnosing the stage, monitoring the ROP course, and promptly referring patients for emergency treatment (laser or anti-VEGF therapy).

Role of physician extenders: more regulation is necessary before full integration into practice.

To discuss the drawbacks and propose recommendations for integrating physician extenders in ophthalmologic practice. In this article, the role of utilizing physician extenders in ophthalmology is discussed. A role for physician extenders has been suggested as more and more patients will require ophthalmologic care. Guidance is needed on how to best integrate physician extenders into eye care. However, quality of care is of the highest importance, and unless there is reliable and consistent training of extenders, using physician extenders to administer invasive procedures (e.g., intravitreal injection) should be avoided due to safety concerns.

E042 The Newcastle Giant Cell Arteritis (GCA) Fast Track Clinic: a clinical service evaluation

Abstract Background/Aims Patients with suspected new-onset giant cell arteritis (GCA) require urgent specialist assessment to establish a diagnosis. Early review reduces unnecessary treatment with high dose glucocorticoids in those without GCA and enhances sensitivity of temporal artery ultrasound. Ensuring patients are rapidly triaged and diagnosed poses a logistical challenge for rheumatology departments working alongside colleagues in both primary care and ophthalmology. To address this, we established a rheumatology-led Newcastle Hospital GCA fast track clinic, a service led by four consultant rheumatologists who perform clinical assessments and temporal artery ultrasound scans. Methods Data were collected prospectively from 2017. We performed a clinical service evaluation based on a retrospective review of clinical records of patients assessed in this service between 2017 to 2020. Results A total of 626 consecutive patients were assessed, with 145 (23%) diagnosed with GCA over the four-year period. Average age was 72 (range 41-96 years) and 452 (72%) were female. The cardinal symptoms of headache, jaw claudication and visual disturbance were present in 518, 103 and 283 patients respectively. The majority of referrals came from ophthalmology (42%) and primary care (34%). 614 patients had an ultrasound scan performed, returning a positive result in 121 (19.7%), negative in 415 (67.6%) and inconclusive in 78 (12.7%). A biopsy was requested for 147 patients over the four-year period; 33 were positive, 95 negative and six were inconclusive. Within this cohort, 47 patients had a biopsy performed despite a negative ultrasound scan, of which five were found to be positive for GCA. Conclusion Our data illustrate the key clinical, imaging and histological findings within one of the largest inception cohorts of GCA in the UK and demonstrate the feasibility of a one-stop rapid access clinical service for patient benefit. Disclosure C.M. Lin: None. J. Berry: None. B. Thompson: None. J. Heaney: None. K. Houghton: None. K. Baker: None. G. Reynolds: None. A. Lorenzi: None.

Prevalence of Risk Factors Among Patients With Glaucoma in Jeddah, Saudi Arabia

Objective The objective of this study is to estimate the prevalence of risk factors among patients with glaucoma in Jeddah, Saudi Arabia. Methods This cross-sectional study was conducted on 215 patients diagnosed with glaucoma in the period between March 2022 and August 2022 at King Abdulaziz University Hospital, in Jeddah, Saudi Arabia. We used the participants’ medical records and contacted the patients to collect information on sociodemographic characteristics and known risk factors of glaucoma. Results Among the 215 patients with glaucoma, 142 (66.0%) patients had open-angle glaucoma, 15 (7.0%) patients had closed-angle glaucoma, and 58 (27.0%) patients had congenital glaucoma. Among the patients with open-angle glaucoma, 122 (85.9%) patients were aged &gt; 40 years, and 99 (69.7%) patients had myopia. Among the patients with closed-angle glaucoma, 13 (86.7%) patients had hyperopia and 10 (66.7%) patients were aged &gt; 60 years. Among the patients with congenital glaucoma, 21 (36.2%) patients had a family history of congenital glaucoma and 28 (48.3%) patients had consanguine parents. Conclusion The prevalence of advanced age, hyperopia, and consanguine parents was the highest among patients with open-angle glaucoma, closed-angle glaucoma, and congenital glaucoma, respectively. These findings could inform public health policies among practitioners involved in ophthalmological care.

Diabetic retinopathy screening integrated in a multidisciplinary diabetes care clinic: a pilot project

ObjectifPrésenter les caractéristiques des patients adressés à une clinique multidisciplinaire unique située dans un centre de soins tertiaires en vue d'un dépistage de la rétinopathie diabétique (RD). MéthodesOn a réalisé une étude rétrospective regroupant des patients qui ont été adressés à la clinique d'endocrinologie cardiaque et rénale d'un centre de soins tertiaires (University Health Network) en vue d'un dépistage de la RD entre avril 2019 et mars 2020 et entre novembre 2020 et août 2021. Ont été recueillis et analysés les paramètres suivants : données démographiques des patients; mesures des atteintes micro- et macrovasculaires; acuité visuelle; pression intraoculaire; images du fond d’œil et résultats de la tomographie par cohérence optique (OCT). RésultatsSur les 64 patients qui se sont présentés à la clinique, les 21 patients (33 %) qui avaient un diabète de type 2 ont bénéficié d'un dépistage de la RD sur place. Les 43 autres patients ont fait l'objet d'un dépistage de la RD dans les 6 mois suivant leur rendez-vous ou bénéficiaient déjà de dépistages annuels auprès de leur ophtalmologiste. On a diagnostiqué une RD chez 7 (33 %) des 21 patients qui ont subi un dépistage – 4 cas de RD non proliférante minime, 2 cas de RD non proliférante modérée et 1 cas de RD proliférante – ainsi que 1 cas d’œdème maculaire. Le diabète des patients qui présentaient une RD était significativement plus ancien que celui des patients sans RD (24,5 ± 10,2 ans vs 12,5 ± 5,8 ans; p = 0,0247). Aucune différence significative n'est ressortie quant à la maîtrise de la glycémie, à la tension artérielle, au profil lipidique, à la fonction rénale, à l'acuité visuelle ni à la pression intraoculaire. ConclusionsNotre analyse montre que, pour les porteurs d'un diabète de longue date, le fait d'offrir le dépistage de la RD à même une clinique multidisciplinaire de traitement du diabète pourrait améliorer le diagnostic et la prise en charge de la RD. D'autres travaux de recherche s'imposent en vue de mettre sur pied de telles cliniques et de mesurer leurs effets à long terme sur le devenir des patients.

Первичная отсроченная хирургическая помощь пациенту с боевым ранением глаза

Currently, injuries to the visual organ are one of the most important causes of blindness and disability due to the complicated course of the post-traumatic process and an unfavorable functional outcome, in the vast majority of cases of the able-bodied population. The timeliness of providing highly specialized ophthalmic surgical care is a fundamental factor that allows for the medical and social rehabilitation of patients with various visual organ injuries in the shortest possible time. In turn, the prolongation of the terms of primary surgical treatment dictates slightly different approaches to the conservative and surgical treatment of such patients. Objective. To evaluate the effectiveness of primary delayed simultaneous surgical care for a patient with a penetrating comminuted battle wound of the eye. Material and metods. Patient K., 35 years old, was admitted to the ophthalmological department of the State Medical Institution «OOKB» of Orenburg with complaints of decreased visual acuity of the left eye with the diagnosis: OS – Multiple military trauma. Consequences of penetrating eye injury. Corneal scar. Traumatic cataract. Partial hemophthalmos. Local retinal detachment. Intraocular foreign bodies. From anamnesis: a month ago, during military operations, he received a shrapnel wound to the head. An open penetrating comminuted fracture of the left temporal bone was performed in a military hospital. I did not receive surgical ophthalmological care. Ophthalmological status: Vis OD = 1,0: OS = movement of the shadow at the face. The IOP of both eyes is normal. OS – conjunctiva is injected, a metallic foreign body is embedded in the sclera at the meridian of 7 hours, 5 mm from the limb, the cornea is transparent, the corneal scar, the anterior chamber is shallow, the moisture is transparent, the iris is edematous, the pupil in the center is deformed, tightened for 7 hours, the pupil reaction is slowed down, inhomogeneous opacities in the lens. The reflex is dim, the details of the fundus and vitreous are not ophthalmoscoped. Preparatory measures were carried out before the surgical intervention: antibacterial and anti-inflammatory therapy. At the first stage, phacoemulsification of traumatic cataract with posterior continuous capsulorexis was performed in the conditions of medical mydriasis. The second stage was a standard three-port vitrectomy of 25 G with the removal of organized vitreous blood clots and the removal of the posterior hyaloid membrane. During the revision, a parietal foreign body with local retinal detachment is visualized in the middle outer part. A 23 G tweezers were used to remove the foreign body, which required the replacement of one of the ports. Delimitative endolasercoagulation was performed. The foreign body was removed through the posterior capsulorexis: brought to the iris in the anterior chamber of the eye, then evacuated through a tunnel incision of 2.75 mm. Then a perfluoroorganic compound (PFOS) was introduced, the retina was attached, additional retinal endolasercoagulation was performed. At the third stage, a simultaneous replacement of PFOS with silicone oil was carried out. The Miol-soft intraocular lens was implanted. At the last stage, the embedded foreign body of the sclera was removed, the conjunctival wound was sutured. On the fifth day after surgical treatment, the patient was discharged for outpatient follow-up with the functions of vis OS = 0.2 sph (+) 4.0 = 0.4 with recommendations. Conclusions. As a result of simultaneous high-tech vitreoretinal surgical treatment against the background of anti-inflammatory and antibacterial therapy, high functional results were achieved. Keywords: injury, penetrating wound of the eye, foreign body of the eye, local retinal detachment