Vol 20, No 4 (2025)

BACKGROUND: In the Russian Federation, the number of children with visual disability decreased by 4% in 2022 compared with that in 2014. Disability rate was 4.9 and 5.1 per 10,000 children, respectively. However, childhood visual disability rates vary greatly in the federal districts of the Russian Federation.

AIM: The study aimed to analyze the clinical entities and changes of childhood visual disability rates in the Arkhangelsk region in 2006–2023.

METHODS: A retrospective (with an analysis of medical records), cross-sectional, comparative study was conducted. It included data on cases of primary childhood visual disability and confirmation of visual disability status in the Arkhangelsk region in 2006–2023. The data were obtained from the annual reporting forms of the Main Bureau of Medical and Social Expert Evaluation of the Arkhangelsk region (Federal State Statistics Service Form No. 7-D (human services), Information on the Medical and Social Expertise of Children Under 18 Years of Age) and reports from healthcare facilities in the region used to generate an ophthalmic statistics note of the Arkhangelsk region.

RESULTS: Over the last 10 years, primary disability rates have hardly changed in the Arkhangelsk region. General childhood disability rate decreased from 24.3 to 23.0 per 10,000 children over 10 years, whereas rates of primary childhood visual disability were 0.61 and 0.64 per 10,000 children in 2014 and 2024, respectively. A total of 38 children confirmed their disability status in 2024, the rates were 2.0 and 6.5 per 10,000 children in 2024 and 2012, respectively. Overall childhood visual disability rates in the Arkhangelsk region were 6.42 and 7.0 per 10,000 children as of January 1, 2025 and in 2012, respectively. For overall childhood visual disability in 2024, the proportion of refractive errors decreased significantly (from 32.3 to 13.9%) compared with that in 2014. However, the proportion of other disorders increased, including retinal disorders (from 14% to 20.5%), optic nerve atrophy (from 10.1% to 18%), and developmental abnormalities (from 6.7% to 12.3%). The proportion of adult people with visual disability since childhood was 6.85%.

CONCLUSION: A comprehensive analysis of childhood visual disability identified the key contributing clinical entities. In addition, the data obtained will help to develop an action plan to prevent and reduce childhood visual disability based on available healthcare resources of the region.

BACKGROUND: Medial eyelid avulsion is one of the most common injuries of the periocular adnexa. Primary surgical repair of such injuries is often performed by ophthalmic surgeons without sufficient experience in oculoplastic techniques, and at times by surgeons of other specialties. In these situations, wound edges may be closed using coarse interrupted sutures placed through all tissue layers or by layered closure without precise alignment, without restoration of the ligamentous structures, and without consideration of the status of the lacrimal canaliculi. As a result, patients develop cicatricial deformities of the eyelids and palpebral fissure, accompanied by epiphora and a pronounced cosmetic defect.

AIM: To present the key stages and evaluate the effectiveness of primary surgical repair of medial eyelid avulsion, considering anatomic features and timing of injury.

METHODS: A single-center, uncontrolled clinical study involved patients with medial eyelid avulsion, including cases combined with lacrimal drainage system injuries. All patients underwent primary surgical repair with lacrimal canalicular intubation. The key steps of the procedure were analyzed, including essential aspects of reconstruction and restoration of the lacrimal drainage pathways, ensuring anatomic integrity and functional competence of the eyelids with achieving a satisfactory cosmetic outcome.

RESULTS: The study included 46 patients with recent trauma of the periocular adnexa. Injury to the lacrimal drainage system was identified in 78.3% of cases. After primary surgical repair, healing in all patients occurred within the usual timeframes. Skin sutures were removed on days 9–10. The silicone stent was removed after 2–4 months depending on injury characteristics and extent of damage. After stent removal, lacrimal irrigation was performed in all patients. Restoration of eyelid contour and palpebral fissure shape was achieved in all cases. Patency of the lacrimal drainage system was restored in 29 patients (78.1%).

CONCLUSION: Successful restoration of eyelid integrity and lacrimal drainage function depends on timely and professionally executed primary surgical repair. Consideration of time elapsed since injury, tissue condition, anatomic features of the eyelids and adnexa, and the use of appropriate suture materials is essential. In medial eyelid avulsion, canalicular intubation facilitates preservation of lacrimal drainage patency and prevents epiphora, whereas accurate layered closure with precise wound-edge alignment ensures optimal healing and restoration of eyelid function.

Sjögren Syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, primarily lacrimal and salivary ones. Notably, this disorder rarely occurs in children. Slit lamp examination with fluorescein and lissamine green staining and Schirmer’s test are required to diagnose Sjögren syndrome. However, the most informative method is a biopsy of the salivary and lacrimal glands, followed by histological examination of the biopsy specimen. Sialography provides additional valuable information and shows changes in the structure and patency of the excretory ducts. Blood enzyme-linked immunosorbent assay reveals rheumatoid and antinuclear factors and, in most cases, anti-SS-A/Ro and anti-SS-B/La antibodies.

The article describes a clinical case, unique for the Samara region, of chronic autoimmune systemic lesions of the connective tissue with involvement of the exocrine glands, mainly lacrimal and salivary ones. It also describes clinical presentation and diagnostic workup, including a comprehensive examination by relevant specialists required for diagnosis, and provides its results and treatment. Sjögren syndrome is an incurable disease requiring constant supportive therapy. In severe cases, it can considerably reduce the quality of life and result in disability of the patient.

Myopia is one of the most common ocular disorders in children and adolescents, and its progressive forms are becoming a global medical and social problem. The World Health Organization predicts that myopia will affect over 5 billion people by the middle of the 21st century. Interestingly, it develops most often in school-aged children. It is critical to study the mechanisms of its progression, including genetic predisposition, accommodative dysfunction, and scleral structural changes. This review presents current data from Russian and non-Russian studies of the pathogenesis and ocular morphology in myopia. Optical, pharmacological, and surgical strategies for myopia control are discussed. Biomechanical properties of the sclera and new technologies to improve them are reviewed. The role of prophylaxis is also summarized. An analysis of current strategies shows that effective management of progressive myopia is ensured only by a comprehensive interdisciplinary approach including clinical, experimental, social, and environmental measures. The article highlights that further multicenter studies are warranted to assess the long-term safety and effectiveness of the proposed strategies. The findings are useful to both researchers and clinicians treating children with myopia.