Diagnostics and comprehensive recovery treatment of an astenic form of accommodative astenopia in an asteno-neurotic state of psychosomatic genesis. A clinical case

Овечкин, И. Г.; Юдин, В Е; Гаджиев, И. С.; Кожухов, А. А.; Беликова, Е. И.

doi:10.21516/2072-0076-2020-13-4-83-86

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Говоря о терапии аккомодационных расстройств, необходимо отметить, что определение формы АА обеспечивает адекватное лечение: при ПИНА требуются «расслабляющие» аккомодационную мышцу методы, при АФАА лечение направлено на повышение объёма абсолютной аккомодации [58,59]. В связи с этим идеология применения конкретных методов у пациентов с АА основана на накопленном опыте нехирургического лечения прогрессирующей близорукости, указывающем на необходимость амбулаторного курса стимуляции зрения на основе специальных аппаратов и физиотерапевтического воздействия (как базового элемента) с последующим проведением поддерживающих мероприятий (методы самокоррекции зрения, медикаментозная «поддержка») в домашних условиях.…”

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

Belikova,

Gatilov,

Ovechkin

et al. 2023

Russian Medicine

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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.

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Section: Additional Informationunclassified

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

Belikova,

Gatilov,

Ovechkin

et al. 2023

Russian Medicine

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Objective study of accommodation in keratoconus

Averich¹,

Abugova²,

Aslamazova

2022

jour

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Background. Keratoconus (KC) is the most commonly diagnosed corneal ectasia among young adults today. The asymmetric process of progression of the KС determines the occurrence of anisometropia, which in a compartment with increased audience and the absence of proper optical correction leads to a violation of the accommodation function that has not previously studied with this pathology.Purpose: to study the work of accommodation using an objective method of computer accommodation in young people with newly diagnosed keratoconus (КC).Material and methods. Thirty (60 eyes) people were included in the study, of which 15 people (30 eyes) formed the main group and 15 (30 eyes) formed the control group. The main group consisted of patients with newly diagnosed bilateral KC: 15 eyes – stage 1, 13 eyes – stage 2, 2 eyes – stage 3 of the disease). Patients of the control group had a history of mild myopic astigmatism of the direct type. The average age of the patients was 23.5 ± 3.1 years. All patients underwent standard ophthalmological examination: autorefkeratometry, visometry and biomicroscopy. In addition, the main keratometric parameters of the cornea were examined using the Scheimpflug analyzer Pentacam. An objective assessment of the indicators of the accommodative ability of the eye was carried out using computer accommodation on the Righton Speedy-I device. The statistical processing was carried out in the IBM SPSS Statistics 23 program.Results. The results of the analysis of accommodograms in both groups demonstrate the predominance of disorders of the ciliary muscle, which manifested themselves in the form of habitual-excessive accommodation tension (HEAT) and accommodative asthenopia of a spasmodic nature. In the control group, in 76% of cases, there was a pattern of excessive accommodative response by the type of HEAT. The state of accommodation in the group with KC in 68% of cases was characterized by an excessive and unbalanced accommodative response, with an unstable course of the curve. The average indicator and the curve of the accommodogram significantly exceeded the indicators of the control group, which proves an unstable state of accommodation in KC. In comparison with the control group, a decrease in coefficient of growth of the accommodogram (CR) by 37% (p < 0.05) was recorded, confirming the absence of a smooth and increasing course of the accommodative response following the stimulus. Analysis of high-frequency the coefficient of microfluctuation (CMF) demonstrated a 10% increase in the work of the ciliary muscle (p < 0.001). The correlative dependence of these parameters with visometry and autorefractometry data has been established.Conclusion. The objective method of accommodation assessment revealed abnormalities of ciliary muscle functioning in patients with a first-time diagnosis of KC, which correspond to the phenomena of spasmodic accommodative asthenopia. The established correlation between CR and CMF with the data of visometry and autorefractometry suggests a potential improvement of accommodation functioning under conditions of optical correction with contact lenses.

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The effect of contact correction on the state of accommodation in patients with keratoconus

Averich

Abugova²,

Aslamazova

2023

jour

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Introduction. Keratoconus (KC) is a disease belonging to the group of primary keratectasias, characterized by pronounced irregularity of corneal topography and accompanied by irregular astigmatism, myopic refraction and higher order aberrations. It is established that accommodation in cases of ametropia is strongly influenced by the wave front of eye, but the influence of aberrations on ciliary muscle work in KC remains unstudied. The aim was to study the correlation of accommodation in KC with the ectasia-induced aberrations before and after optical correction with scleral rigid contact lenses (SRCL).Materials and methods. Thirty people (60 eyes) with newly diagnosed bilateral KC, were included in the study: 26 eyes – stage I, 29 eyes – stage II, 5 eyes – stage III. Mean age of the patients was 26,2 ± 4,3 years. The clinical recruitment period was from January to September 2022. All patients were additionally evaluated for keratometric and aberration parameters of the cornea using a Scheimpflug camera besides a standard ophthalmological examination. Objective evaluation of accommodation was performed on the Righton Speedy-I device with determination of qualitative and quantitative indices. All investigations were performed before and after one month of wearing individual SRCL.Results. According to the data of objective accomodography a state of spasmodic accommodation asthenopia was observed in 71% of cases before started wearing pressure lenses. There was a tendency to improvement of ciliary muscle function and a “stepped” course of the accommodative curve while wearing SRCL a month later. High values of corneal aberrations decreased by 4.5 times in the course of SRCL. Correlation analysis revealed a significant trend between the state of accommodation and the corneal wavefront.Conclusion. Objective examination of the accommodation state in KC proves the signs presence of accommodative asthenopia mediated by irregular astigmatism. The revealed correlations between the indices of induced KC aberrations and accommodation state confirm the fact of ectasia negative influence on ciliary muscle work. It was proved that optical correction with SRCL in KC reduces corneal aberrations and significantly improves the state of accommodation.

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Diagnostics and comprehensive recovery treatment of an astenic form of accommodative astenopia in an asteno-neurotic state of psychosomatic genesis. A clinical case

Cited by 3 publications

References 5 publications

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

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

Objective study of accommodation in keratoconus

The effect of contact correction on the state of accommodation in patients with keratoconus

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