1. Optics Professor Damian Czepita Department of Ophthalmology Pomeranian Medical Academy Szczecin, Poland http://sci.pam.szczecin.pl/~czepita

4. EMMETROPIC EYE Image: true, reversed, reduced Refraction: cornea43,5 D lens19,1 D aqueous humor boundary membrane of the vitreous vitreous body Total58,5-64,2 D

5. NEAR AND FAR POINT Near point: The closest situated point from where exiting rays of light are refracted on the retina. Far point: The farthest situated point from where exiting rays of light are refracted on the retina.

6. RANGE AND AMPLITUDE OF ACCOMMODATION Range of accommodation: The distance between the far and near point. Amplitude of accommodation: The range of accommodation in D.

7. AGE, NEAR POINT, AMPLITUDE OF ACCOMODATION 10 years7 cm14 D 20 years 10 cm10 D 30 years 14 cm7 D 40 years 22 cm4,5 D 50 years 50 cm2 D 60 years 100 cm1 D 70 years infinite 0 D

8. PRESBYOPIA After the 40th year of age: Decrease in elasticity of fibers and capsules of the lens.

9. SENILE HYPEROPIA After the 60th year of age: Decrease of the refractive index in eye tissues, especially in the cornea and the vitreous body.

10. READING GLASSES 40 years of age+1 D 50 years of age +2 D 60 years of age +3 D

12. CLASSIFICATION OF MYOPIA AXIAL - too long axis of the eye, normal strength of the optic system REFRACTIVE – normal length of the eye axis, too strong optic system

13. CLASSIFICATION OF MYOPIA LOW< -4 D MEDIUM-4 – -8 D HIGH> -8 D

14. CountryAreaAge (years) Myopia (%) Hyperopia (%) ChileUrban5-156.816.3 ChinaUrban5-1535.10.8 ChinaRural5-1516.23.5

15. CountryAreaAge (years) Myopia (%) Hyperopia (%) IndiaUrban5-157.47.7 IndiaRural7-154.10.8 MalaysiaUrban7-1519.31.3

16. CountryAreaAge (years) Myopia (%) Hyperopia (%) NepalRural5-151.21.4 PolandUrban/ Semirural 6-1813.313.1 South Africa Urban/ Semirural 5-152.91.8

18. OCCURRENCE OF MYOPIA Stickler syndrome Marfan’s syndrome Ehlers-Danlos syndrome Weill-Marchesani syndrome homocystinuria

19. OCCURRENCE OF MYOPIA McCune-Albright syndrome Kniest syndrome Down syndrome Prader-Will syndrome Noonan sydrome

20. OCCURRENCE OF MYOPIA Cohen syndrome Rubinstein-Taybi syndrome Cornelia de Lange syndrome fetal alcohol syndrome Knobloch syndrome

21. OCCURRENCE OF MYOPIA congenital night blindness deficiency of ornithine aminotransferase deficiency of prolidase premature infants lack of a sufficient amount of calcium, fluoride and selenium in food

22. READING OR WRITING VS. MYOPIA P <0,001 READING/ WRITING MYOPIA PRESENT MYOPIA ABSENT TOTAL < 2 H6,44% (n=93) 93,56% (n=1351) 100% (n=1444) 2-3,5 H12,15% (n=269) 87,85% (n=1945) 100% (n=2214) > 3,5 H16,77% (n=360) 83,23% (n=1787) 100% (n=2147) TOTAL12,44% (n=722) 87,56% (n=5083) 100% (n=5805)

23. COMPUTER VS. MYOPIA P < 0,01 COMPUTERMYOPIA PRESENT MYOPIA ABSENT TOTAL < 0,8 H11,45% (n=392) 88,55% (n=3033) 100% (n=3425) > 0,8 H13,85% (n=338) 86,15% (n=2102) 100% (n=2440) TOTAL12,45% (n=730) 87,55% (n=5135) 100% (n=5865)

24. TELEVISION VS. MYOPIA P > 0,05 TVMYOPIA PRESENT MYOPIA ABSENT TOTAL < 2 H13,76% (n=232) 86,24% (n=1454) 100% (n=1686) 2-2,5 H11,46% (n=237) 88,54% (n=1831) 100% (n=2068) > 2,5 H12,34% (n=253) 87,66% (n=1798) 100% (n=2051) TOTAL12,44% (n=722) 87,56% (n=5083) 100% (n=5805)

25. INHERITANCE OF MYOPIA MONOGENIC: autosomal dominant autosomal recessive X-linked POLYGENIC: < -6 - chromosome 1 ? > -6 – chromosome 1-4, 7, 8, 10-12, 17, 18, 22

27. CHILDHOOD MYOPIA is the most often met form of myopia. It occurs before and during maturation.

28. PROCEDURES IN CHILDHOOD MYOPIA exercises in plus glasses when looking far away reading in prisms temporary usage of spectacles keeping hygiene of the visual work: correct illumination, reading from a distance of 30 cm, doing breaks during visual work

29. PROGRESSIVE MYOPIA develops after birth to the 30-35 years of age. It is characterized by its fast course.

33. PROCEDURES IN PROGRESSIVE MYOPIA drugs sealing the vessels and improving circulation: Calcium, Extract vaccinium myrtillus, Pentoxifylline, Rutoside, Xantinol nicotinate biostimulating drugs: Aloe extract, Extract total eye, Peat bog extract, Placental extract, Sea slime extract vitamins: A, B 1, B 2, B 6, B 12, C, D, E, F, PP diet with plenty of fresh fruits and vegetables

34. PROCEDURES IN PROGRESSIVE MYOPIA permanent usage of spectacles keeping hygiene of the visual work: correct illumination, reading from a distance of 30 cm, doing breaks during visual work laser treatment: photocoagulations of degenerative changes in the retina and choroidea

40. SUBSTANCES INHIBITING THE PROGRESS OF EXPERIMENTAL MYOPIA PIRENZEPINE - antagonist of the muscarinic M 1 receptors, APOMORPHINE - unselective agonist of the dopamine receptors.

44. CLASSIFICATION OF HYPEROPIA AXIAL - too short axis of the eye, normal strength of the optic system REFRACTIVE - normal length of the eye axis, too low strength of the optic system PHYSIOLOGICAL < +3 D

46. ASTIGMATISM A refractive error, which causes rays of light passing through the refractive planes of the eye to be differently refracted.

48. ORIGINS OF ASTIGMATISM Corneal astigmatism: deformation in the anterior and posterior surface of the cornea Lenticular astigmatism: deformation in the anterior and posterior surface of the lens, decentralization of the lens, irregular refractive index of the lens

49. ORIGINS OF ASTIGMATISM Corneo-lenticular astigmatism Others - for examaple deformations of the posterior part of the eyeball

51. ANISOMETROPIA Different refractive errors in the left and right eye. AXIAL - different length of the eyeball REFRACTIVE - different strength of the eye’s optic system

55. LACK OF FUSION > +5 D > -6 D

57. OPTICAL ADVANTAGES OF CONTACT LENSES Are able to fully correct even very high refractive errors. Do not limit the visual field. Do not create oblique beam astigmatism. Do not create aniseikonia greater than 10%. Do not create micropsia in high myopia.