In recent years, there have been significant positive changes in the organization of ophthalmological care for children, formed the legal basis for the provision of medical care to children with ophthalmopathology, increased the availability and quality of medical care, detectability of ophthalmopathology (6%), increased the results of treatment, which reduced the level of primary disability per 10 thousand of the child population in the Russian Federation has declined from 1.4 in 2004. to 0.9 in 2016. Early treatment has helped reduce blindness and low vision in 2.6 times (from 58.4 in 2009 up to 22.7 in 2016). The rapid development of pediatric ophthalmology is due to the introduction of new highly informative objective methods of research, high-tech surgical and laser treatment in the leading ophthalmic centers of Russia: Federal clinical recommendations on diagnosis, monitoring and treatment of children with retinopathy of prematurity (active phase), myopia, congenital cataracts, retinoblastoma, concomitant strabismus, congenital glaucoma, uveitis associated with juvenile idiopathic arthritis, congenital pathology of lacrimal pathways in newborns and children of the first year of life have been developed and put into practice.

On April 4–5, 2019, the Russian Helmholtz National Medical Research Center of Eye Diseases held a scientific and practical conference with international participation «Retinopathy of prematurity and retinoblastoma 2019». The conference, which became a platform for discussion of the most acute and burning issues of pediatric ophthalmology, was a great success. The proceedings reflect the state-of-the-art in the treatment of infants and children with retinopathy of prematurity and retinoblastoma, new technical and methodological solutions, controversial issues, and future prospects.

Purpose. To provide updated and expanded indications for YAG laser surgery in ocular diseases of children, developed on the basis of 25 years of experience, for the introduction into the broad practice of pediatric ophthalmology in the Russian Federation. Material and methods. The indications were developed on the basis of the analysis of results in 4422 laser reconstructive surgeries (62% in conditions of general anesthesia) for children from 2 months to 17 years (1/3 children – up to 3 years) with congenital, post-traumatic, postinflammatory eye pathology performed by the authors in the Pediatric Department of the Moscow Helmholtz Research Institute of Eye Diseases from 1991 to 2016. There were used combined laser installations including the IAG laser destructor (1064 nm) and Argon or Diode laser coagulator (532 nm) and the laser tehniques adapted for children and their own patented methods. Results. The safety of laser interventions in children with strict observance of the fulfilled energy parameters of laser operations has been proved. The efficiency of the 4422 YAG laser surgeries performed to children (after 2-16 years was 87.7 to 97.3%), the long-term experience and improvement of laser techniques allowed to expand the spectrum of laser interventions in children and to work out a list of indications for the YAG-laser reconstructive surgery in children with the ophthalmic pathology. Conclusion. The YAG laser reconstructions are recommended for pupillary membranes (including congenital, secondary, membranous and regenerative), precipitates on the IOL, linear vitreo-, iridocorneal synechias, pupil block, deformation, dislocation or obturation of pupil, cysts of the iris and anterior chamber, flocculi of the pupillary margin, internal fistulae obturation after trabeculectomy, thin vitreous strands, and also for anterior capsulotomy (as a stage of the subsequent extraction of cataracts, especially with subluxation of the lens). The main kinds of reconstructive laser operations recommended for introduction into the practice of pediatric ophthalmology of the Russian Federation are presented as for illustration exemplary.

The work is devoted to one of the most relevant problems of ophthalmology and neurophysiology which is the study of interhemispheric interactions in children with ophthalmopathology.The purpose of this work is to study lateral phenotypes in children with ophthalmopathology.Patients and methods. 374 6–15 years old children were observed: 1) 160 children with non-paralytic strabismus; 2) 111 children with organic pathology of the retina and the optic nerve; 3) 103 children of the control group (without ophthalmopathology). The lateral phenotype (LP) was determined according to the scheme “dominant hand — dominant ear — dominant eye”.Results. Different LP ratios were obtained in the examined groups of children (p < 0.001). The ratio of right-handers / left-handers / ambidextrous children was most uniform in the group of children with non-paralytic strabismus (43,8 / 22,5 / 33,7 %). In the group of children with organic ophthalmopathology it was “shifted” to the right-hand side (65,8 / 10,8 / 23,4 %). In the control group the number of left-handers was minimal, and the number of ambidextrous was maximal (51,4 / 3,9 / 44,7).Conclusion. It was found that children with organic ophthalmopathology are characterized by the most pronounced predominance of right-sided LP, and children with non-paralytic strabismus are characterized by a relatively uniform distribution of right-sided, left-sided and symmetrical LP. The identified features may reflect increased left-hemispheric activity in children with organic ophthalmopathology and adaptivecompensatory increase in right-hemispheric activity in children with non-paralytic strabismus. 

Visual motor coordination (VMC) is the coordination of the motions and their elements resulting from the collaborative and simultaneous activity of the visual and motor analyzers required for daily activities, sports, and professional activities. The development of VMI begins in the early childhood and proceeds throughout human life being the most active within the first 10 years. VMC is a part of visual motor integration (VMI) defined as a complex combination of skills to correctly execute the movements of arms, legs, and body. The potential causes of impaired VMI are arrested development due to living conditions, organization of teaching, individual developmental or health characteristics; nervous system diseases (i.e., head injuries, cerebrovascular disorders, intoxication etc.); and, in particular, visual impairments. Since the quality of visual functions is an important component of good VMC, its generation and development require adequate vision correction. It was demonstrated that the degree of myopia may affect school performance in the areas requiring VMI. Optical correction of ametropias improves VMC. This should be considered when managing patients (in particular, children) with refractive errors. Keywords: visual motor coordination, visual and motor analyzers, visual functions, optical correction, micro-level orientation, fine motor skills, synchronization. For citation: Egorov E.A., Romanova T.B., Rybakova E.G. Visual motor integration: generation, development, and its importance for ophthalmology. Russian Journal of Clinical Ophthalmology. 2021;21(1):14–17. DOI: 10.32364/2311-7729-2021-21-1-14-17.

Background: the use of botulinum toxin type A (BTA) in ophthalmology for extraocular disorders in children and adults became possible was pioneered by A. Scott in the 1980s. Lack of experience and understudied risks of this treatment modality in Russia prevent the introduction of chemodenervation into daily ophthalmic practice. In addition, several adverse reactions of BTA were reported. Therefore, these adverse reactions should be considered when choosing this treatment in adults and children. Aim: to assess the efficiency and adverse reactions of BTA when treating strabismus in children. Patients and Methods: 212 children (424 eyes) aged seven months to 15 years with estab-lished strabismus were enrolled. Visual fixation and acuity were measured before BTA injection. BTA was injected in horizontal extraocular muscles (average dose 3.40 U). Results: the average angle of strabismus was 33.28±12.96°, the average angle of eso-tropia was 33.69±12.86°, the average angle of exotropia was 31.50±13.41°. Neutralization of strabismus angle was achieved in 92.2%, a reduction in strabismus angle was reported in 7.8%. In total, 288 procedures were performed. 76 patients (35.85%) required re-surgeries. In most cases, re-chemodenervation was performed in children with a strabismus angle >25° (Hirschberg test). Adverse reactions of chemodenervation were blepharoptosis (2.83%), hypereffect (17.45%), conjunctival redness, and edema at the injection sites. These adverse reactions were self-limited, no specific treatment was needed. Conclusion: chemodenervation by BTA injection in hyperfunctional extraocular muscles is a highly effective, non-traumatic, and safe treatment for strabismus in children. All adverse reactions identified by our study were transient. Keywords: botulinum toxin type A, postoperative complications, strabismus, nystagmus, extraocular disorders, chemodenervation. For citation: Sidorenko E.E., Ostanina I.A., Rosel’o K.N.M. et al. Adverse reactions of botulinum toxin type A for treating strabismus in children. Russian Journal of Clinical Ophthalmology. 2022;22(2):145–148 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-145-148.

Despite the comprehensive approach to the organizational system of ophthalmological services in the Russian Federation, several problems occurred concerning ophthalmological care for children aged 017 years. The statistical data study makes the availability and quality of medical care assessment possible in patients in each Russian Federation region, as well as planning the resource allocation, medicinal volume, and technical support. The article is based on the materials of the federal statistical observation in health resources and their activities: Forma No. 12, 14, 30, and 47. A comparative analysis of the state of the ophthalmological service in the subjects of the Russian Federation in dynamics for 20192020 was conducted on the activities of the bed fund, the staff of ophthalmologists, and the structure of ophthalmology in children. An objective health status assessment of the children of the Russian Federation aged 017 years was conducted in morbidity, the prevalence of eye diseases, and its accessory apparatus. Special attention is paid to the importance and the quality of preventive examinations and their connection with morbidity, including primary interaction of structural units of medical organizations that carry out occupational examinations and conduct patient admissions at the place of residence. The presented material is useful in the work of the ophthalmological service, chief freelance ophthalmologists, specialists in organizational and methodological work, and practicing doctors.