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Complicated high myopia is one of the leading causes responsible for the disablement in the children associated with visual impairment especially when it is combined with other pathological conditions and abnormalities among which are disorders of the musculoskeletal system. In the present study, we for the first time examined visually impaired schoolchildren (n=44) who suffered from high myopia complications making use of the computed optical topographer for the evaluation of the state of their vertebral column. The control group consisted of 60 children attending a secondary school. The study revealed various deformations of the musculoskeletal system including scoliosis, misalignment of the pelvis, kyphosis, hyperlordosis, torsion, platypodia, deformation of the lower extremities and the chest. These deformations were more pronounced in the visually impaired schoolchildren in comparison with the children of the same age comprising the control group (p<0,05). It is concluded that the assessment of the state of the vertebral column with the use of the apparatus yields an important information for the elaboration and application of a series of measures for the timely provision of medical assistance needed for the comprehensive rehabilitation of the visually impaired schoolchildren presenting with high myopia complications.

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The refraction condition was analyzed in 670 impaired-vision schoolchildren with various ophthalmic pathologies. Refraction defects were diagnosed in 98.9% of cases. Myopic refraction was detected in 48.9% of cases, while hypermetropic refraction was found in 50.0% of cases. Astigmatism was observed in 97.8% of cases; in 38.6%, it exceeded 2.0 diopters, which was mainly encountered at the retinopathy of prematurely newborns, albinism and congenital myopia. Compound astigmatism was detected in 83.5% of cases and mixed astigmatism was present in 8.3% of cases; the latter was more frequent diagnosed in persons with albinism and with abnormal development of the eyeball. Regular astigmatism was found in 78 > 8 of the examinees, inversed astigmatism was found in 11.0% of cases and squint astigmatism was detected in 10.2% of cases, the last mentioned type was more often found at the retinopathy of prematurely newborns, abnormal development of the eyes and at postoperative aphakia. Anisometry exceeded 2.0 diopters in 21.8% of cases; a high anisometry was more frequent at the retinopathy of prematurely newborns, congenital myopia and aphakia. 7.6% of schoolchildren lacked the subject-vision in the second eye. Nystagmus was registered in 46.4% of children. The spectacle vision correction was found to be effective in 94.8% of cases, however, the severe refractive defects belong to the unfavorable factors for an optimal spectacle vision correction or for creating a full-value binocular vision image. Groups were specified, which are more favorable and more complicated for the spectacle correction of impaired vision. The use of modern contact lenses in the correction of high-degree ametropia, astygmatigmus and anisometry can be of an effective assistance in expanding the indications for a rational optic correction in impaired-vision children.

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The possibility of using diaphragming means for improving the vision of poorly sighted patients is discussed. A total of 279 patients (514 eyes) aged 6-82 years were examined, 118 (42.3%) of these with ocular diseases. Comparative analysis of the time course of visual acuity was carried out in patients using diaphragming means, optimal eyeglasses, and both. Eyeglasses are preferable for the majority of patients with poor vision, as they allow a higher visual acuity than diaphragming eyeglasses. Diaphragming means are more effective in patients with opaque optic media of the eyes with slight refraction disorders. A diaphragming racket is suggested for utilization of the useful characteristics of the diaphragm; it can be combined with eyeglass correction of ametropia. A group of patients was distinguished, for whom the combination of these two types of correction is the most effective: patients with corneal dystrophy, involution cataract, retinopathy neonatorum, aphakia, high complicated myopia, and diabetic retinopathy. In addition, the diaphragming racket is recommended for use during consultations for more accurate evaluation of the correction of ametropia and the intactness of the retinal macular zone in patients with opaque optic media of the eye.

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Tinted eyeglasses were selected for 768 poor-sighted patients aged 5-86 years with various ocular diseases. The frequency of tinted glasses utilization by poor-sighted patients was as follows: filter O2 was the optimal for 38% patients, filters G2 and K4 for 16-18%, and G1 for 11% patients. Filter G1 improved visual acuity by 19%, filters G2 and K4-K5 by 23%; the highest increment of visual acuity was observed with O2 filter: by 27%. Filters of different spectral characteristics and density may be useful in the same underlying ophthalmic disease, which is explained by the underlying disease and the presence, combinations, and severity of concomitant ocular diseases.

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A total of 1012 patients aged 6-94 years (31.9% aged under 19 years, 25.2% aged 20-60 years, and 42.9% aged over 60) with poor sight, 83% of whom could not read book type, were examined. Corrected far visual acuity was 0.03-0.35, in 52.7% of these 0.1-0.2 and in 38.2% less than 0.1. The most incident diseases were retinal and optic nerve disease (40.6%), complicated myopia (15%), congenital ocular diseases (17.3%), aphakia (9.8%), and glaucoma (7.9%). In order to select correction, near visual acuity, reading acuity, and reading speed were evaluated. Optic magnifiers, such as hyperocular eyeglasses, magnifying glasses of different types (supporting, applied, special, manual, and telescopic) were used for correction. Four-fold magnifiers were prescribed most often (67.3%). Optic magnifiers allowed reading in 78% cases. The decisive factors of the device efficiency were reading acuity (no more than 48 points) and reading speed (at least 200 signs/min). Ocular disease, visual field status, patient's age and psychosomatic state, and technological characteristics of the device are also important factors.

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The author analyzes the results of examinations of visual working abilities of 64 poor-sighted children making use of different correction means in reading and compare the data obtained in reading with optic and television amplifiers before and after 15 min reading a text written in standard type. The findings evidence that the work (reading) induced significant functional disorders both in the sensory and motor components of the visual system; in patients with vision acuity of 0.1 or higher vision fatigue was lower if an optic correction means was employed, and in patients with vision acuity below 0.1 diopters the fatigue was lower if a television amplifier was employed. Recommendations on improvement of television devices for reading and employment of various correction means for poor-sighted subjects are given.

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Three new kits of optic devices for the selection of means facilitating orientation in the space, for writing, reading, and other work involving the visual control, and devices that help operate these kits have been developed for rooms organized to correct the vision of poor-sighted patients. Problems of training personnel and rehabilitationologists for work at enterprises for blind people are discussed, as are those concerned with production, use, and realization of optic amplifiers.

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Presented in the paper is a brief analysis of population requiring special aids to correct their reduced vision. Main causes of unsatisfactory optical rehabilitation service for low vision population are determined. The program to improve such a service is proposed. Some preliminary results are discussed.

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