Background. Among all cranial nerves, the facial nerve is the most exposed to birth injuries. Difficulties with medical assistance during the first months of life for children with a facial nerve birth injury is known and debated. According to the literature data, the scope of diagnostic and treatment activities varies, and these treatments have not always demonstrated effectiveness. Aim. We discuss the protocol of medical assistance for newborns and children during the first months of life with a facial nerve birth trauma. Materials and methods. We analyzed domestic and foreign literature dedicated to facial nerve birth trauma. Results. The results showed the necessity of a multidisciplinary approach for patients with facial nerve birth trauma involving neurologists, ophthalmologists, otolaryngologists, audiologists, maxillofacial surgeons, geneticists, doctors for rehabilitation medicine, and microsurgeons. Key directions of medical assistance during the first months of life include the prevention of the development of ophthalmologic complications; topical and etiological differential diagnosis; and dynamic observation to timely resolve whether surgical treatment is necessary. Conclusion. The integration of developed protocols in clinical practice is essential for understanding the etiology, pathogenesis, natural history, differential diagnostics, and prior treatment by medical doctors of different specialties to improve the quantity of medical assistance.
Background. At the present time, the problem of choice of eye drops to achieve adequate mydriasis with minimal side effects for retinopathy of prematurity screening remains an urgent challenge. Purpose. To estimate the clinical efficacy of combination mydriatic eye drops Fenicamide in infants born at different gestation terms. Materials and methods. Under observation, there were 75 newborns (150 eyes) and babies aged from 1 day to 3 months (average, 38.2 ± 32.2 days). Patients were distributed into 3 groups depending on gestational age: group 1 consisted of 25 full-term infants; group 2 – of 25 premature babies, and group 3 – of 25 extremely preterm infants. To achieve mydriasis, 1 drop of combination eye drops (5% phenylephrine and 0.8% tropicamide) was instilled. Dynamics of pupil diameter change in each group of patients was registered within 4 hours, and side effects were recorded within 24 hours. The quality of fundus visualization was estimated using a pediatric retinal camera RetCam 3. Results. Maximal pupil dilation (average, 6.5 ± 0.5 mm) was reached to 60 ± 14 min after instillation on average; pupil remained dilated within 1 hour, its diameter became normal in 4 hours. Mydriasis varied from 5.9 mm in extremely premature infants to 7 mm in the full-term newborns (p > 0.05), and allowed a full and high quality examination of the fundus in all patients, including the visualization of peripheral zones of the retina for retinopathy of prematurity screening. It was established that drug side effects were absent in 76% (57) of infants, they were present in 24% (18) of infants, mostly as local reaction. Conclusion. Fenicamide eye drops are an effective mydriatic medication, with a convenient instillation regimen, have minimal side effects, and can be recommended for retinopathy of prematurity screening and monitoring.
Aim. To develop and introduce into the pedagogical practice a competency-oriented education module. It would be included in all professional competencies of the Federal State Educational Standard for OPHTHALMOLOGY. Material and methods. A nosological form, retinopathy of prematurity, was chosen to create the module. The material was created primarily on the basis of Federal clinical guidelines (FKR), retinopathy of prematurity, active phase. For the electronic information and educational environment of the university and for contact work, tests and case studies were prepared and competency-oriented tasks were compiled for all 12 professional competencies (PCs) registered in the Federal State Educational Standard for Ophthalmology, dated October 27, 2014 (No. 34470). Results. The educational module, including all PCs, was developed and introduced into practice in the Department of Ophthalmology at North-Western State Medical University named after I.I. Mechnikov; this can serve as a reference model for the development of similar modules in other important and relevant areas in ophthalmology to enhance both the residency program in ophthalmology and cycles of thematic improvement for practicing ophthalmologists. Conclusion. The competency-oriented tasks developed for the module are a useful resource in both learning and evaluation of residency programs in ophthalmology and thematic improvement of ophthalmologists.
Introduction. The retinopathy of prematurity (ROP) is a leading condition in the nosological structure of ophthalmic pathology in preterm children. A number of researchers note the increase in frequency of glaucoma development in such patients, considerably worsening the prognosis of the disease. At the same time, features of ocular hydrostatics and hydrodynamics taking into account the immaturity of the eye are studied insufficiently. The purpose of the study was to estimate the anterior chamber angle anatomy in preterm children with glaucoma depending on the cicatricial ROP severity. Materials and methods. The study group included 45 preterm children (87 eyes) aged from 6 months to 18 years with glaucoma on the background of cicatricial ROP. The control group consisted of 27 full-term children (54 eyes) with congenital glaucoma. As an addition to traditional ophthalmologic examination, iridocorneal goniography using a pediatric retinal camera was performed. Results. In children of the study group, anomalies of anterior chamber angle anatomic structure were diagnosed in the absolute majority of cases 97.7% of cases (85 eyes) and depended on the cicatricial ROP severity: at degrees 1-3 they were similar to those in congenital glaucoma in full-term children; at degrees 4-5 glaucoma was of secondary nature and developed as a result of a combination of dysgenesis signs in the anterior chamber angle. Conclusion. Cicatricial ROP of any degree is a high risk factor for the development of secondary glaucoma.
This article is devoted to the description of three clinical cases of retinoblastoma, two in young children and one in a fetus, from our own ophthalmology practice.
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