[000:00:00;00] achieve victory. glory to the defense forces of ukraine , we are moving forward. explain to the children the rules of behavior with changes, so that they do not go into the forests, fields, rivers, battles, do not enter destroyed buildings

, do not approach mines, and how will they see them

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in ukraine thanks for the transformation, you have questions, you will get answers, so questions are waiting how to deal with portnikov september every friday at 21:15 for an espresso hello this is freedom morning informational project of radio svoboda then guests every day this is the shipping district of kherson turn on live we are somewhere in the vicinity of bakhmut we tell the main thing on weekdays at 9:00 vasyl's big broadcast in winter, two hours of air time, two hours of your time, two hours to learn about the war and what the world is like, two hours to keep up with

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the draft economy news with andriy yanitsky on weekdays at 8:10 no espresso dad who were you during the war a defender a defender so more than 280 million people in the world suffer from visual impairments this is data from the world health organization

ophthalmologists note that this number increases every year for example if we take our in the country, according to statistics, in 2017, about one and a half million cases of eye diseases were registered, among them more than 300 thousand cases in children, but you and i have added more problems in connection with this, people need the help of ophthalmologists and these people i congratulate all the viewers of the espresso tv channel. this is a program about health and i am iryna koval, so i think you have already guessed that today we will talk about our vision, how to preserve it, but not just in the context of such everyday problems, but the topic of our broadcast will be more important today we will find out whether the eyesight of ukrainians really worsened during the war and we will talk about who provides ophthalmological surgical rehabilitation to soldiers of the armed forces of ukraine and also to civilians who suffered from it. and we will also talk about

reconstructive surgical interventions and so i i want to introduce you to the guests who visited my studio today. well, you probably all know my favorite ophthalmologist serhiy rykov p . serhiy. greetings, members, correspondent of the national academy of medical sciences of ukraine, professor, head of the department of ophthalmology and optometry, postgraduate education of the national medical academy of ukraine named after bogomolets and iryna galinska p. iryna welcome to our studio today candidate of medical sciences assistant of ophthalmology and optometry postgraduate education of the bogomolets national medical academy of ukraine practicing plastic ophthalmologist surgeon so, first of all, my dear guests, what i want to ask you about today, is it really true that during the war the stars of ukrainians got worse

? is it still a myth to take children even like that ? i often consult children, and parents come and say that it got worse the eyesight of young children is very often simply not checked before the war, and we sometimes find deterioration of eyesight for the first time. and here are the children with a slightly older head in the corners, who have visual strain, who had coronavirus strain on the eyes, eh ipads then military situations, when we are already working online, you also understand how big the visual load of the accommodation apparatus is, because it is built in such a way that it must look at a distance of more than 5 m, and we all the time find work from up close, and the eyesight has really deteriorated, mainly this is a violation of accommodation, it is not catastrophically, the child will not be blind from this, you just need to give the right recommendations and according to certain rules to engage

in zympad, but the deterioration is felt in the adult population, especially 40 plus people used to start using reading glasses before the age of 45, and now they are 38-40 years old and so on. and they think that this is, for example , a neuropsychological situation, and neurologists and psychiatrists also support us because when we say , we show the statistics of visual impairment but it is important that at the same time there are no organic changes on the fundus, it is possible to get a reverse reaction and cure pa is it very important but realistic because the president of ukraine said that he and his wife began to see poorly after of these nervous stresses and then we thank god the journalists paid attention. yes, and the ophthalmologists are simply very satisfied because more patients came to us who came for preventive examinations, this is very important for me

, among the 15 patients at the reception last week there were just three children the parents brought me for a preventive examination, they really have myopia, the children don’t have it yet, and we will be able to give advice ms. iryna , do you agree? i often see such pathology as glaucoma patients in connection with the war, due to the fact that they are forced to leave their homes and have lost contact with their ophthalmologist, their vision decreases, they do not regularly instill, for example , anti-glaucoma drops, they do not regularly visit their doctors and thermologists because , as you know, a patient with glaucoma must have a comprehensive ophthalmological examination once every six months, and unfortunately, these patients are forced not to follow the doctor's recommendations and contact with

therefore, glaucoma is already a disabling disease, it leads to loss of vision. but this condition in others leads to the fact that these patients have progressive deterioration of vision, and this is also quite a difficult problem for a patient who has gone abroad. and who will provide them with help there, who will prescribe the necessary drugs for example, the necessary therapy was selected here. and this is also a very important component and cause of vision impairment, and i also want to add that there are diseases that require, for example , intraveterial injections of certain medical drugs inside the eye, and these drugs are designed in such a way that it is necessary to adhere to a clear schedule of administration of these drugs and when the patient does not receive this dose of the drug at the appointed time, it even leads to irreversible changes in the eye and also loss of vision, so there are many components why our patients, unfortunately, really lose their vision with cataracts, for example, patients come already in

the advanced stages. that is, we operate with modern technology - they have not been examined and do not know. they do not want to spend money on this, but there are some patients who pay funds and want to come for surgery because the situation may be unstable tomorrow we have to run somewhere maybe to the basement maybe somewhere else and here these patients are just the very stage of cataract, it turns from immature to mature well , it seems that it is good if it is mature then to operate no it is not good because the lens then very dense and technologically bad for the surgeon . remove this lens and the patient has a much longer postoperative period because of that. i really want to appeal and say that our patients should not sit through a lot of ophthalmologists in all regions. there is enough

you just need to contact the network in a timely manner. as soon as you see that it is cloudy in front of your eyes constantly, it is not cloudy today, it may be from general pressure and then pass. if the cloudiness appears in front of your eyes, you can see worse in the distance, but better up close, then you have to go before that, not the intervention of iryna correctly said about glaucoma, because it is uh, the regimen of using drops is violated in 95% of patients, and glaucoma is the main reason for squinting. so there are going to be more blind people in our country and there is a lot of war in our country military and civilians will be received according to the degree of severity and it is very important that they receive timely, high-quality medical care . so , how are our wounded treated and who is involved in it? families, iryna galinska

knows firsthand how our defenders sacrifice their health for the sake of a free land. at the beginning of the invasion, the doctor and her colleagues helped the defenders of zhytomyr oblast. after the first battles before clinics transported many wounded soldiers. since the beginning of 2014, the clinic cooperates with providing assistance to military personnel and those injured as a result of russian aggression, but unfortunately , after 2022, the number of these injured and those military personnel who need medical assistance has increased many times. the staff cooperates with a local hospital. fighters from with the most serious wounds. and to treat the disease, soldiers are sent to a clinic, although it is private, but defenders are treated here

for free, which means we examine for free, about 80 servicemen every day receive such free examinations as laboratory diagnostics, i.e. blood tests, computer tomography , magnetic resonance tomography, x -ray of any department, as well as specialist consultations, recently there has been an increase in the number of requests from the military with ophthalmological problems to the doctors, vadym kalinchuk, a man at the beginning of the invasion , i volunteered and recently began to feel that my vision had worsened, and it did not worsen much, but it worsened from the moment when i i was an ophthalmologist. i once understood that i was driving with my eyes closed and the spring forced me to go to the ophthalmologist with many patients like vadim . every day, the ophthalmologist receives four servicemen. soldiers with concussions often turn to all the procedures related to head injuries, plus, after the concussion,

the vision is partially lost. the left side of hearing from the mirner disappeared. therefore, i am currently undergoing an eye examination here for the time being, this is probably in the last four months, it is probably already 4 contusions, sharp vision on the front is worth its weight in gold says soldier mykola vushanov for military hearing and eyes are the basis of all the basics. you hear. thanks to modern equipment, the clinic can make accurate diagnoses and subsequently start the necessary treatment if it's just myopia or er, that is, myopia or some kind of astigmatism. usually it can't be corrected. - only laser correction helps in this, if it is some kind of post-traumatic impressions, then it is usually

the case. they carry out free surgical interventions, doctors also treat the children of fallen servicemen, children undergo medical examinations until they reach adulthood, therefore, the clinic calls on military personnel who need the help of specialized specialists to contact the institution directly or through their hospital. so we return to you, our viewers. this is a program about health i am iryna kovalyu. today i have serhii rykov, a corresponding member of the national academy of medical sciences of ukraine, professor, head of the department of ophthalmology and optometry, as my guest. of postgraduate education of bogomolets national medical university and i want to introduce another guest who is on our air . this is iryna galinska

, candidate of medical sciences, assistant of the department of ophthalmology and optometry of postgraduate education of bogomolets national medical university , practicing plastic ophthalmologist, surgeon. yes, soldiers who were wounded , and i have a question for you. how long does such rehabilitation actually last and the main problems that you see that are addressed our military thank you for such a question, rehabilitation has been going on for a long time, more than a year, and these patients must be dealt with comprehensively from the point of view of ophthalmology, from the point of view of neurology, and with the help of a psychologist and even with the help of a cosmetologist. as you know, there is a lot of support in our country of our foreign european e-e pharm pharmaceutical companies that help to do joint care because always reconstruction of the face, reconstruction

of the eyelids are combined injuries and they need not only surgical recovery but also recovery of work with scars, this is the administration of special drugs so that the products do not become hard, and they contribute to hard scars because, uh, they violate the anatomy and physiology of the eyelids, and accordingly the eyeball itself suffers, this is also laser grinding methods and therefore, i very sincerely thank everyone who participates in the comprehensive rehabilitation of our military wounded and even the civilian population by doctors of all specialties with symbiosis, that is, there is absolutely collegiality and support is the work of an ophthalmologist, a plastic surgeon, a cosmetologist, and it gives the best result. then, of course, there is one more point, that rehabilitation is really up to a year or more. for example, we discussed the problem of eye prosthetics with a powerful author so well when a fragment just hit

their eye they removed the eye and there is a cavity. and when it needs to be formed, as oksana vasylivna petrenko says, it takes 3-4 stages, it can take more than two years, and the number of individual prostheses is planned to be much larger prosthetics, that is, rehabilitation, two-thirds of the work of ophthalmologists in polyclinics after the war will be the rehabilitation of primary patients, there will be less because the population is a little smaller, and the treasure will be less, but the rehabilitation must be comprehensive , multidisciplinary. professor kobchak and i are from the center for maxillofacial physiology in surgery, we restore, for example, the septum of the eye, the lower part, i.e. we do special 3d against e-e modeling and so on, i.e. the recovery is almost complete, but the main thing is that these patients are difficult if there is no eye - it is a general

a contusion is a patient with brain problems, problems, problems that need care for this patient, and here they are already acting at the next stage, these are long-term rehabilitation centers where patients can be , as you said, where not only there, let's say two or three days, but several months ago, i wanted to ask sergius about this, where is this rehabilitation taking place in ukraine, are there any private hospitals, are there special sanatoriums, are they state hospitals, what kind of bookmarks is the hospital in tsibly , for example, yes, he is from mozovsky, there are many of hospitals from the mbd, from the military, from the border guards, etc., yes, state institutions, of course, because private institutions take for a certain period, for example, i know one clinic , a private clinic in kyiv. you understand the long and hard rehabilitation, and private individuals are trying to do

some volume of surgical intervention , high-tech. still, this is a state matter, not the rehabilitation of soldiers, and here is the training of personnel, especially rehabilitators takes the first place, you understand. in your favorite specialty, it was maxillofacial talmology in dentistry, let’s say in ent because it is combined damage and this is what our national medical university and the institute of postgraduate education deal with because we work with doctors of postgraduate education and it is important that to date, there is a good , powerful team of the institute, which practically the doctors are satisfied with. they write now wherever you want, we are afraid, we love them and we are afraid that they will write any kind of review, you understand here too uh, there is an incentive to work even better, to report something new. only something was seen immediately to the doctors, immediately to the doctors, because the patients are injured , they come where they go to their mother's house or to

their woman because of that. so it should be regional . in fact, it is very important because the war is not over yet and we understand that these problems will be long and the post-war period . it is important that these doctors, ophthalmologists , rehabilitators, be in our country, mr. sergiivno, but how many are there now, at the moment , you say that they are, but how many are there well, according to the calculations, these are european calculations, because we have statistics. now there is a bit of a problem, because there is a shortage of uh, about 30 percent of rehabilitators will be needed , that is, doctors, and about 50 percent of the middle level, that is, those who will do massages and carry out various procedures, etc. mrs. ira, i want to hear what you still see, if it concerns both military and civilians , mainly what kind of injuries are these injuries? i would like to thank you for

raising such an important topic because if a military man is admitted to the hospital and the doctors are already rehabilitating him, the patient is a civilian he does not know who to turn to and maybe this program will help and give the post to turn to doctors because there are such complex injuries that the patients of their civilian relatives give up injuries are related to the fact that they not only cause a decrease in vision, but also deform the face, and first of all, this is a psychological , significant, significant injury, because it is the absence of an aesthetic cosmetic effect. so this is a defect, and you said it correctly serhii oleksandrovych said that now the cooperation of maxillofacial plastic surgeons has quite a lot of opportunities and it is very good that our patients, our ukrainian people, knew that they have hope to return to a healthy life thanks to the fact that 3d plates are actually being produced now. they are fully

integrated into the skull. - this is the bony basis of our beautiful visual face, and already from this it is already possible to build up soft tissues and results in long-term and rehabilitation, it is usually more than a year, it is necessary to have patience for the patient in the first the first step is not for the doctors, the doctors have patience, but for the patient, for his family, to bring this result to the maximum desired. and when the patient already sees the first positive steps , then it is easier to cooperate with him, but regarding the nature of these injuries. unfortunately, in most cases, these are shrapnel injuries. these injuries are also shrapnel injuries of the eyelids, the orbits of the eyeball itself, shrapnel injuries, they usually carry pollution in addition to themselves . yes, these are infectious complications. that is, it is a severe combined trauma of burns. less is more

work, after all, of the surgical department. rehabilitation i wanted to say the best after the surgical stage - this is the family why do patients come to me like this almost blind warrior is almost blind but the family is already adapted to this, you understand, they understand what to expect what are the stages of presentation and i tell them what the future is there is a young man, there are special technologies, er, there is now an experiment , for example, this is the growth of neuroepithelial cells themselves on the eye, if the person has atrophy of the optic nerve, yes, there are already such molecules, there is no such drug yet, but it will be in 5 years you understand and they come, they are calm, they do not demand anything from the doctor. they are waiting for this information in the future. at home

, they also treat psychologically , it is very important that it concerns . which completely imitate how it is even with the use of make-up. so when a person puts on completely imitates the other half of the face, which is how you communicate from afar, then you don’t even you will understand that a person has a defect, because a person really needs social adaptation. she should not be afraid to go to the store and talk with friends, so it is important to convey information that not everything is lost . now there are many opportunities, the main thing is to find your specialist who will guide you on this path of rehabilitation, then please tell me how expensive it is in general . does the state still cover all of this? is it possible to see the military

? there is no question at all. if a military man comes and shows his ticket, no clinic in ukraine will take it. well, money is an immoral thing, and everyone understands that. we are even glad that you came to us, we even fight, we want the patient to come to us . well, if we are a high-tech clinic, then if we say something that we cannot do, then yes, and by the way, manufacturers and firms american, european, er, they provide consumables for these surgical interventions for free, you just have to submit an application to examine the patient and in two weeks they provide us with these materials, and i want to er, by the way, say that we ukrainians are so a strong nation that all private clinics, even they have rallied and i provide help to both the military and the civilian population , free of charge or only for some small expenses, materials because we all understand that only we can help each other, and that's why , uh, go to private clinics, there are many private clinics on its pages in social networks, it even makes announcements that contact us, we will help you

with reconstruction free of charge, and there are many associations, there are associations of ophthalmoplastic surgeons, oculoplastic surgeons, there is an association ukrainian e-e critical surgeons from the original catherine surgeons and they are supported by foreign sponsors and there are applications when surgeons come, and it seems to me that both in lviv and in poland when patients e-e are usually selected and they come from america and from large european centers and absolutely free of charge for the patient, they perform high-tech and expensive operations. well, there are 9-hour long operations, so the main goal is to spread the word and give knowledge of where to turn for this, that is, i want to you have this opportunity right now to address all our viewers who have such problems and to the military and civilians who have been injured so that they are not left alone

with their problem and so that they can turn to doctors an extremely very important point is the help of europe and america 's ophthalmologists themselves with knowledge conferences, that is , earlier, to invite some european surgeon to give us a lecture , we had to pay him 3,000 €. now everyone gives lectures for free, we are just initiating we are conducting training, but now we have a very big euroretinal congress and we have all gathered at the ophthalmologists of ukraine, and we now have half of the lecturers are foreign and wonderful lectures , that is, european knowledge by european scientists are being brought to the ophthalmologists of ukraine today, and in such a difficult time , our very many young doctors continue to study and recently there was also a conference in prague and for ukrainians there was absolutely free registration and there was