Dissertation

Theme: system of the restoration of visual functions in refractive and disbinoclular amblyopia in children and adolescents
Year: 2009
The thesis addresses the most relevant issues of pediatric ophthalmology – the design of corrective methodologies for patients with amblyopia. Amblyopia is an important sign of visual system maladaptation that results in such functional disorders as binocular system impairments, strabismus, asthenopia.

This pathology does not only often lead to the expressed visual function decrease, but also to the psychological and social problems of patients in their everyday life todayas well as in the professional sphere in the future. Parents will have to spend a huge amount of time and effort on children’s treatment.

The result of the big clinical work that has been done are:
  • Development of a principally new effective scheme of the comprehensive functional amblyopia recovery of the visual functions that takes into account the visual perception impairment specifics, type of amblyopia, the amblyopic eye refraction, the nature of the vision and the patient’s age;
  • Development of innovative objective methods of the visual acuity and accommodation function examination including visual evoked potential registration that for the first time allowed to determine the visual perception parameters and detect functional visual impairments with high resolution in patients of young age and patients with refractive amblyopia. Carrying out this research in real time made it possible to determine the influence of these functions on the entire visual perception complex.
  • for the first time, on the basis of the complex examination of amblyopic patients, the technique and the indications to the surgical correction of mixed astigmatism in children with refractive amblyopia and high visual acuity were defined. Additionally, surgical correction of ametropia as the final stage of visual function recovery in patients with astigmatism complicated by refractive amblyopia was proposed. This allows to significantly increase visual acuity, absolute accommodation reserve and visual  performance indicators as compared to conservative management.
  • Modernization of the Cuppers’ Fadden-operation in children with disbinocular amblyopia with cyclic strabismus and microstrabismus makes it possible to almost completely neutralize the conditions provoking amblyopia recurrence as compared with traditional surgical methods.