No abstract

Accommodation disorders in young people are more common than diagnosed. This review is based on the data of domestic and foreign literature and studies the effect of contact lenses of various designs on accommodation. Particular attention has been given to bifocal soft contact lenses as one of the recognized interventions for treating juvenile progressive myopia and their ability to slow axial elongation. Key words: accommodation, myopia control, bifocal contact lenses, orthokeratology.

The increasing prevalence of myopia is observed all over the world, and Russia is no exception. In this regard, obtaining new data on its epidemiology among children and assessing methods of its control in real clinical practice are highly topical matters.Purpose. The purpose of this work was to assess the current issues of the epidemiology and treatment of progressive myopia in children in various regions of the Russian Federation.Materials and methods. We conducted a prospective multicenter epidemiological observational questionnaire study. This study involved 106 doctors from 53 regions of Russia and 2931 parents of myopic children.Results. 50% of the surveyed doctors noted that the manifestation of myopia is diagnosed in children aged 10–12 years, while 43% noted the same in children aged 7–9 years. According to 74.5% of doctors, the degree of the newly diagnosed myopia ranges from –1.25 to –3.00 diopters, 25.5% of doctors reported that it is below –1.0 diopters. The majority of doctors (73.6%) assess accommodation in myopic children, considering it one of the progression factors. 52.9% of ophthalmologists prescribe optical correction in cases when monocular distance visual acuity amounts to 0.6 (decimal scale) or lower values, while 29.2%, 16% and 1.9% of the surveyed ophthalmologists prescribe optical correction in cases when monocular distance visual acuity amounts to 0.7, 0.8 and 0.9 respectively.The following optical methods for juvenile myopia control are recommended by the doctors: orthokeratology contact lenses (53.8%), spectacles for full correction (51.9%), peripheral defocus-inducing (bifocal) soft contact lenses (18.9%), while 4.7% of the surveyed doctors utilized other methods of myopia control, which were not indicated in the questionnaire.Conclusion. In most cases, manifestation of myopia is diagnosed in children aged 7–12 years. Its degree ranges from –1.25 to –3.0 diopters, which indicates its late diagnosis; optical correction is prescribed mainly in cases when monocular distance visual acuity is 0.6 or lower; most ophthalmologists assess accommodation in myopic children, considering it a progression factor. As methods of myopia control, doctors utilize optical correction, device-assisted therapy and pharmacological treatment of accommodative disorders, while parents prefer methods that require minimum time expenditures.

The purpose of this guide is to introduce ophthalmologists and optometrists to the basics of fitting of customizable soft contact lenses, which is an important knowledge that enhances practitioners’ skills and helps provide a high visual acuity for many patients.Material and methods. This guide sets forth the principles of calculation of contact lens parameters, defines parameters specific to customizable lenses as well as assessment of the fit and the rules of lens handling and care.Conclusions. Following the fitting guide ensures a successful vision correction with customizable soft contact lenses for both doctor and the patient.

The use of contact lenses (CLs) in children and adoles¬cents is a topical subject that attracted even more atten¬tion during recent years due to the improvement of ma¬terials and types of CLs. According to research, more than 2 million children and adolescents use soft CLs in the USA alone. This results from both broad medical indications for the prescription of CLs and social reasons. The age at which contact lenses can be recommended for children is also an important subject that is being under debate. While some ophthalmologists believe that children can be introduced to soft contact lenses from the age of 12 years old, others think that the minimum age should be 14 years old. Some doctors, however, are against using contact lenses in children. Optometrists, not having the right to conduct cycloplegia, prefer to prescribe contact lenses to adolescents over 14 years old. On the other hand, the selection of CLs for children and adolescents does not depend on age, but on the indications for their application.