Ophthalmology

OPHTHALMOLOGY (from the Greek ophthalmos - eye and logos - science), the doctrine of diseases of the eye and its accessory parts. The name was first introduced by the Göttingen professor Himmly (K. Himmly) in 1801. Diseases of the organ of vision are so noticeable and so sensitively affect its function that at the dawn of human culture they must have attracted attention and served as a subject of treatment. It is therefore not surprising that in the most ancient monuments containing more or less systematic information about medical knowledge, a prominent place is given to eye diseases. Of the six canonical books devoted to medicine found in the tombs of ancient Egyptian pharaohs, one deals specifically with eye diseases. In the so-called collection of Hippocrates, there is a description of the eye and its diseases; among the latter, besides diseases of the connective and corneal membranes, relatively accessible to observation, there is among other things night blindness - a nosological unit established only on the basis of complaints of patients and doing credit to the attentiveness and generalizing ability of physicians of that era. In the works of Celsus, the expression of pressing cataracts is encountered for the first time, an operation which was undoubtedly performed in ancient times. A very detailed description of the eye, its diseases and methods of their treatment is given by Galen. At the level of knowledge of the latter, the doctrine of eye diseases remained almost until the 17th century, despite the fact that after the fall of the Western Roman Empire, Greek medicine continued to be diligently cultivated first in Byzantium, and then by the Arabs. The manuals on eye diseases preserved from this period were written mainly by Arab doctors; containing a number of valuable individual observations, they nevertheless abound in the grossest errors from the point of view of modern knowledge. O. could only set out on the path of real progress after the general growth of natural science knowledge, which began in the Renaissance era, had created the necessary basis for this. The clarification of the dioptrics of the eye by Kepler had direct and enormous significance for the development of O. On the one hand, this laid the foundation for the correct understanding of anomalies of eye refraction and their appropriate correction by glasses. But even earlier, the result of Kepler's research was reflected in the change of view on the essence of cataract. Before Kepler, the lens was considered the light-sensitive part of the eye. Therefore, it was not only impossible to think of removing the lens from the eye, but it was also impossible to imagine that blindness, removable by operation, could depend on the disease of the lens itself. Kepler proved and Scheiner confirmed this with a beautiful experiment, that images of objects are obtained not on the lens, but on the retinal membrane, and reduced the significance of the lens only to its refractive ability. A short time later, Brissaud clarified that cataract depends not on the appearance of a film in front of the lens, as was hitherto imagined, but on the clouding of the lens itself, which logically led to a new method of cataract operation, introduced by Daviel in the middle of the 18th century and bringing about a tremendous revolution not only in the treatment of cataract itself, but in the entire organization of ophthalmological affairs. If until this time the most important eye operation - removal of cataract - was performed by a primitive method, accessible and actually practiced by the most unqualified practitioners, the extraction of cataract according to Daviel represented a surgical intervention requiring from the doctor a certain scientific training. Since the advantages of the new operation soon became fully apparent, the treatment of cataract from the hands of wandering 'oculists' and barbers inevitably had to pass into the hands of more qualified doctors-surgeons, who at the same time began to be interested in other eye diseases'. In this way, at the end of the 18th century, modern scientific O. began to be laid, the further development of which went hand in hand with the development of the rest of medicine. In all countries of Western Europe, mainly in capitals and large cities, institutions for the treatment of eye patients gradually began to appear. Individual doctors began to be engaged mainly, very rarely exclusively, in the treatment of eye diseases. A number of new manuals on O. appeared, which differed favorably from the previous ones both in their anatomical-physiological part and in the presentation of treatment methods, mainly of a surgical nature. Teaching of O. in universities and medical schools was then in the hands of professors of surgery. Only in Austria-Hungary in 1818 was a separate department of eye diseases established at the University of Vienna, which was taken by Beer (J. Beer); in the next 20 years, similar departments were created in all other universities of the country. This measure for a long time placed the Vienna school of ophthalmologists in one of the first places. In other states, the example of Austria-Hungary was not soon followed. Here they waited for the moment when O. in its development would make a rapid leap and in a short time would become so rich in theoretical and practical terms that the rights of this discipline to a separate place among medical sciences became indisputable. This leap, called by the historian of O. Hirschberg (J. Hirschberg) the 'reform of O.', took place in the 50s and 60s of the 19th century and is associated with the names of two physiologists - Helmholtz and Donders - and the clinical ophthalmologist Graefe. Helmholtz in 1851 invented the eye mirror - ophthalmoscope (see), which made it possible to see the posterior part of the eye in the living eye, which was completely inaccessible to research before. Donders systematized and developed the accumulated by that time information about the dioptrics of the eye in relation to the conditions actually encountered in humans. In his book 'Anomalies of Refraction and Accommodation of the Eye' Donders presented this difficult section of the physiological optics of the eye in such an accessible form that it easily became the property of practical O. Correction of refraction anomalies by glasses, which had hitherto been in the hands of poorly knowledgeable empiric-opticians, became the business of an ophthalmologist based on mathematical data. At the same time Graefe in Berlin, one of the first in Germany to devote himself exclusively to O., abandoning the speculative concepts of humor pathology, which was already losing ground, concentrated all the rational accumulated by previous centuries in the treatment of eye diseases and studied by him in the leading ophthalmologists of that time, widely applied the latest achievements, in particular Helmholtz's ophthalmoscope, and enriched O. with a multitude of remarkable observations and fruitful ideas, why he is rightly recognized as the founder of modern O. Thus, by the middle of the 19th century, O. finally separated into a special specialty, which to a large extent acquired a special technique. Working with an eye mirror, with a set of optical glasses required both special technical skills and special theoretical training. At first, attempts were made to combine in the hands of one specialist O. with otorhinolaryngology, but this combination proved unstable, and these areas began to be developed theoretically and applied practically completely separately. Even Graefe in 1867 was appointed the first ordinary professor of O. at the University of Berlin. Earlier, departments of O. were established in Germany in Leipzig (1853) and in Munich (1863), and after Berlin, all other German universities soon received independent departments of O. The example of Germany was gradually followed in the entire cultural world, and teaching of O. was put on a solid footing. The activity of Graefe left its mark on the further development of O. for a long time. He attracted a large number of student-doctors, many of whom only under his influence devoted themselves to O. Among them were representatives of different countries, from America to Russia inclusive, but the majority of his students were Germans. Many of them later took over departments of O. in German universities and actively continued to develop ophthalmological science in various directions. Germany thus became the center of ophthalmological scientific thought, and a significant majority of subsequent works in the field of O. belong to German ophthalmologists. Reviewing the development of modern O., which began with Graefe and continues to the present moment, one can outline in it a number of stages, not sharply limited in time, but still differing in characteristic features and indicating the main milestones along which ophthalmological thought moved. If the first half of the 19th century with the beginnings of scientific O. can be called the pre-ophthalmoscope period, in which mainly diseases of the anterior part of the eye and operative technique of cataract, optical iridectomy, strabismus, etc., were developed, then for the second period, covering the third quarter of the 19th century, the use of an eye mirror for studying diseases of the posterior part of the eye is primarily characteristic. Here virgin soil opened up for the work of the ophthalmologist. At first, almost every new patient represented a scientific discovery.

Through the work of Graefe, Ruete, Coccius, Jaeger, Donders, Liebreich, and others, typical diseases of the fundus of the eye were described—excavation of the optic nerve in glaucoma, embolism of the central artery of the retina, the picture of thrombosis of the central vein, choked disks, atrophy of the optic nerves, changes in the retina in nephritis, pigmentary degeneration of the retina and its detachment, syphilitic disease of the uvea, glioma of the retina, sarcoma of the uvea, etc. Guides to ophthalmoscopic examination were compiled and the first atlases of ophthalmoscopic pictures were published (Liebreich, Jaeger). In addition to clarifying the nature of various visual disorders, these ophthalmoscopic studies played a special, remarkable role in the development of Ophthalmology. As a result, Ophthalmology, which had emerged as a separate specialty, not only did not lose its connection with the rest of medicine, but this connection turned out to be much closer than was initially assumed. The ophthalmoscope revealed at the bottom of the eye (in the retina and optic disk) diseases that turned out to be consequences or a constant companion of disorders of internal organs (nephritis, diabetes, blood diseases, brain tumors, etc.). Moreover, the visual disturbances caused by these changes in the fundus often lead patients to the ophthalmologist at a time when the internal disease has not yet had a marked effect on the patient's general condition and does not cause corresponding complaints. The closest dependence was discovered between changes in the eye and general diseases of the body, fraught with diagnostic and therapeutic prospects, and the development of questions in this area began to attract the greatest forces (Forster, Leber, Uhthoff, Wilbrand, Behr, and others) and yielded rich results. For the next period of Ophthalmology, works of a pathological-anatomical nature must be considered characteristic. The study of the pathological anatomy of eye diseases began in the first half of the 19th century, but the founder of the pathological histology of the eye was the anatomist and pathologist Heinrich Müller (H. Müller), who became interested in this field not without the participation of Graefe, to whom Ophthalmology is indebted for the development of the technique of pathological-histological examination of the eye* by a series of works on pathological changes in albuminuric retinitis, pigmentary degeneration of the retina, capsular cataract, etc. (1856-1858). In Müller's laboratory in Würzburg, the pathological histology of the eye was studied and numerous workers of the new Ophthalmology prepared themselves for independent work in this field. The successes of cellular pathology prompted ophthalmologists to clarify under the microscope changes they had clinically observed in both the anterior and posterior segments of the eye. Pathological-histological research, mainly of eyes enucleated for various reasons, was diligently applied by a number of ophthalmologists and greatly contributed to clarifying the nature of inflammatory, degenerative, and other lesions of the eye, its oncology, etc.* This work, in which Schweigger, Becker, Leber, Michel, Fuchs, and others have special merits, continues to the present time; its results are summarized in the capital, richly illustrated collective work 'Pathological Anatomy of the Eye' edited by Wessely (K. Wessely). Following microscopic research, often combined with it, methods of experimental pathology penetrated into Ophthalmology and received wide application. In the last decade of the 19th century, a new stage can be noted in the development of Ophthalmology, expressed in the attraction of bacteriology for clarifying the etiology of eye diseases. The corresponding research of Uhthoff and Axenfeld, Morax (Morah), and others clarified the importance of pneumococcus in the etiology of creeping ulcer of the cornea and purulent traumatic infections of the eye, and also led to the discovery of special pathogens (Koch-Wicks bacillus, diplobacillus of Morax-Axenfeld), pathogenic for the connective tissue, partly the corneal membrane, and causing typical inflammations of these parts of the eye. The book by Axenfeld, 'Die Bakteriologie in der Augenheilkunde,' which appeared in 1907, gives an idea of the enormous work done by ophthalmologists in this direction. On the basis of bacteriological research, a technique for testing the conjunctiva before operations on the eyeball was also developed. The beginning of the 20th century, under the influence of the teachings of Mendel, which had just become known, was marked in medicine by an increased interest in the phenomena of hereditary transmission of diseases. Ophthalmologists had earlier drawn attention to the hereditary nature of certain eye diseases (color blindness, pigmentary degeneration of the retina, the form of atrophy of the optic nerves described by Leber). Mendelism gave an impetus to further research, which added to the previously known a large number of newly described hereditary eye diseases, to a large extent changing previous ideas about the origin of so-called developmental defects of the eye, and, what is especially important, shedding new light on the question of the refraction of the eye, in particular on the origin of myopia (A. Steiger). In recent years, finally, a trend can be noted in Ophthalmology that seeks to use the successes of biochemistry to explain the pathogenesis of certain eye diseases (Jess Goldschmidt). Along with the listed, partly transient trends in ophthalmology, the fine clinical differentiation continued uninterruptedly and gave the greatest results, identifying a large number of new nosological units that remained unknown to previous observers. As an example, one can name from corneal diseases—discoid keratitis, congenital degenerative changes of the cornea; from retinal diseases—tuberculous periphlebitis, angioma, etc. Functional research of central and peripheral vision, which turned out to be extremely important for the diagnosis of both local eye diseases and lesions of the central visual pathways, continued to attract attention and was constantly being improved (Förster, Snellen, Bjerrum). Much was done in the field of diagnosing disorders of color perception, which acquired great practical significance (Holmgren, Stilling, Nagel). Much effort was put into refining the objective examination of the eye; the most important successes on this path are the simplification of Helmholtz's ophthalmometer with its adaptation for clinical purposes (Javal) and the introduction into clinical practice of tonometry of the eye (Maklakov, Schiotz). On a large scale in all countries, operative Ophthalmology was developed, and not only were the achievements of general surgery (asepsis, plastic operations) used and appropriately modified, but also new special, very valuable operative methods were introduced, especially in the treatment of glaucoma. Drug therapy also developed greatly, enriched with myotic agents (pilocarpine, eserine), preparations of silver (protargol, argyrol), attempts were made at specific chemotherapy (otoquin). Finally, the continuing research in physiological optics, which gave through the works of Gullstrand (A. Gullstrand) extremely valuable practical results both in the diagnosis of eye diseases (reflection-free ophthalmoscope, slit lamp) and in the correction of anomalies of refraction, acquired special significance. The practical application of Gullstrand's ideas in the last 15-20 years has become a new field of activity, widely and very fruitfully developed by a number of ophthalmologists (Fogt, Köbner, etc.). It deserves attention that the scope of Ophthalmology in its modern development has significantly expanded. Initially, anatomical-physiological information about the structure and function of the eye was obtained by Ophthalmology from anatomists and physiologists; the first pathological-histological studies of the eye were also carried out not by a specialist ophthalmologist, but by a pathologist (Müller). Later, however, the pathological anatomy of the eye became exclusively the property of ophthalmologists. The same must be said about bacteriological research. Specialists-physiologists of the second half of the 19th century paid much attention to the organ of vision (König, Hering, Nagel, Kries), but in this field too, the work of ophthalmologists occupies a very prominent place (Leber, Hess, Parinaud, Gullstrand). Normal anatomy, histology, and embryology of the eye are also gradually becoming a field of activity for the modern ophthalmologist (Leber, Sattler, Greff, Szily). Thus, the content of Ophthalmology increasingly goes beyond the science of eye diseases and approaches the original definition of Himmli, according to which Ophthalmology should be 'a comprehensive science of the eye in its healthy and diseased state.' It is quite natural that the 'leading' role in this belongs to the 'workshop' of the ophthalmologist—the ophthalmological clinic. In Germany, in 1876-1887, 8 university eye clinics were newly built. Before the World War, 8 more were added to them. In the construction of clinics, the interests of patients and teaching are widely taken into account, but also the needs of scientific research work. Laboratories adapted for the most diverse, including experimental, research, libraries supplied with all the specialized literature, have become a necessary and usual part of the ophthalmological clinic. Through the work of staff in many of them, museums of pathological-anatomical, comparative-anatomical, embryological specimens have been compiled. All these conditions greatly facilitate scientific work and contribute to its effectiveness.

Following the German model, clinics were later established in other countries, often even more grandiose. As in other areas of medicine, a significant stimulus to scientific creativity was provided by special ophthalmological societies, congresses, and the periodic press. The first ophthalmological society was formed on the initiative of Graefe in Germany and began to hold annual congresses in Heidelberg. Following the German example, such ophthalmological societies arose in all countries. Later, local associations of ophthalmologists were also formed. The German ophthalmological society has retained the greatest significance to this day, whose congresses attract a large number of participants not only from Germany but also from other countries. From 1857 to 1929, 12 international ophthalmological congresses were held. The specialized periodic press on ophthalmology has grown tremendously and is now published in almost all languages of civilized peoples. The first European ophthalmological journal, 'Annales d'oculistique,' has been published since 1838, founded by Cunier. According to Merz's count at the beginning of the 20th century, 38 ophthalmological journals were being published. The 'Archiv f. Ophthalmologie,' which began publication in 1854 under the editorship of Graefe, has to this day retained its significance as the main scientific organ for ophthalmology. The most widely considered journal is the third German journal in chronological order, 'Klinische Monatsblätter für Augenheilkunde.' Periodically published critical reviews on various departments of anatomy, physiology, and pathology of the eye (Ergebnisse), as well as publications of the Handbuch and encyclopedia type, were very important aids for scientific work. The current state of ophthalmology appears as follows. 1. Possessing well-developed diagnostic methods that allow not only to examine but also to measure almost all parts of the eye, ophthalmology is probably the most precise medical specialty; doubtful diagnoses here are extremely rare, and there are almost no disagreements in diagnosis. 2. Ophthalmological examination has acquired enormous, often decisive importance for the recognition of a number of internal and nervous diseases. 3. Operative ophthalmology, thanks to the use of local anesthesia, asepsis, bacteriological examination of the contents of the conjunctival sac, numerous technical improvements of previous operative methods, and the introduction of new ones, has reached a high degree of perfection, reducing the previously very common postoperative inflammations to very small numbers and giving successful results in cases (removal of foreign bodies and parasites from the back of the eye, removal of new growths from the orbit, etc.) which were previously considered inaccessible to operations. 4. Local drug therapy possesses a number of very effective means and has become more rational, partly being conducted on the basis of bacteriological research (inflammation of the conjunctiva). 5. Patho-anatomical, experimental, and clinical research have significantly expanded knowledge of the etiology and pathogenesis of eye diseases, in particular their dependence on general infections of the body, syphilis, tuberculosis, etc., on lesions of the glands of internal secretion, and thereby created the basis for rational therapy. While noting all these achievements, it cannot be overlooked that the problems of the pathogenesis of cataract and glaucoma and the etiology of trachoma have not been resolved to this day, despite the fact that since the inception of scientific ophthalmology they have undoubtedly been at the center of its attention. Ophthalmology in the USSR. Like other branches of medicine, ophthalmology penetrated into Russia from Western Europe, mainly from Austria-Hungary and Germany. The first information about oculists or 'eye masters' in Russia dates back to the 17th century. In the records of the Apothecary Order, oculists David Brun, who lived in Russia from 1628 to 1651, Johan Malghorn (1659-1673), Johan Schartling, who arrived from Hamburg in 1676, and some others are mentioned. All of these were foreigners, partly taken prisoner during the war and partly came at the invitation; they mainly served the royal court and the army. In the 18th century, the establishment of medical education began in Russia, first in medico-surgical schools at hospitals, and then in the newly established Moscow University. In addition, in 1783, the Kalinin Medico-Surgical Institute was opened in St. Petersburg, where teaching was conducted in the German language. There are indirect indications that in these medical schools, treatment of eye diseases was also taught. Only about the Kalinin Institute is it definitely known that in the 1780s, Professor of Obstetrics and Physiology Karl Brandau taught there a 'full course of eye diseases and the surgical operations required by them.' And in the 19th century, at the medical faculties, to which from 1802 were added the Dorpat, Kazan, Kharkov, and from 1844 the Kiev faculties, ophthalmology was still taught for a very long time not independently, but together with surgery. At Moscow University, ophthalmology was first taught by Professor of Surgery Hildebrandt, from 1823 to 1846 by Evenius, who had been entrusted to teach ophthalmology as well as desmurgy and mechanurgy, later by surgeons Basov and Matyushchenkov. The same was the case in provincial universities. Only at the Medico-Surgical Academy in St. Petersburg in 1818 was a separate department of ophthalmology established. It was held by Grube until 1834, and in 1835, with the change of the Academy's charter, the department was abolished, and teaching of ophthalmology also passed to the professor of surgery. Dr. Lerkhe in St. Petersburg and Dr. Brossé in Moscow have great merits for Russian ophthalmology during this period. The first is actually the founder of the St. Petersburg Eye Hospital (now named after Girshman), of which he was director from 1824 to 1847. The second created the Moscow Eye Hospital in 1826. Both of them received special education abroad, mainly in Vienna with Weer, were very devoted to their profession and showed great organizational abilities. The institutions they created, existing to the present day, played the largest role as centers of practical ophthalmology, always standing at the height of modern science and serving as a nursery of ophthalmological knowledge. Only in 1860 were departments of ophthalmology with clinics established at Moscow University and at the Medico-Surgical Academy in St. Petersburg, and during the next decade similar departments were opened in provincial universities. The first professors of ophthalmology at Russian universities—Yunge in St. Petersburg, Braun in Moscow, Ivanov and Mandelstam in Kiev, Adamyuk in Kazan, Girshman in Kharkov—all thoroughly prepared for their activities in long foreign business trips, mainly in Germany. Most of them exactly fulfilled the program developed at that time for postgraduate students in ophthalmology: 'to study anatomy with Müller in Würzburg, physiology with Helmholtz in Heidelberg, and clinic with Graefe in Berlin.' They came to Russia as representatives of the new, reformed ophthalmology of Graefe with ready skills for scientific work. Here they not only successfully developed a large practical work in the treatment of eye diseases, not only taught thousands of students the basics of modern ophthalmology, but also prepared in their clinics a significant number of qualified specialists and educated students—their successors at the department. Through the activities of the first professors, academic ophthalmology in Russia was raised to a high level, not inferior to the Western European level. Thanks to the preserved and later custom of foreign business trips, the second generation of professors of ophthalmology (Dobrovolsky, and after him Belliarminov in St. Petersburg, Maklakov and Kryukov in Moscow, Khodin in Kiev, Agabasov in Kazan, Barbashov and Braunstein in Kharkov) remained in close contact with Western science. The heaviest oppression in Russia in the last decades of the 19th and early 20th centuries was naturally not favorable for the development of scientific work. The horrifying growth of eye diseases among the population, especially in areas affected by trachoma (Kazan, Kharkov and Kiev), cultivated by the conditions of the capitalist-landlord regime, doomed doctors to fruitlessness, since the bourgeois-landlord clique that dominated Russia at best left a narrow base for the organization of ophthalmological help, providing no possibility for its development. And if nevertheless a number of names emerged in the field of ophthalmology (A. V. Ivanov, who made a significant contribution to the normal and pathological anatomy of the eye, A. N. Maklakov, F. O. Yevetsky, S. S. Golovin), then the regime that dominated Russia at that time was least of all to blame for this. Despite it, due to a number of conditions of the struggle against autocracy, ophthalmology developed on its specific basis. Original guides on ophthalmology written by Russian scientists (Khodin, Kryukov, Mandelstam, Adamyuk) appeared, a special journal 'Vestnik Oftalmologii' was founded by Khodin in 1884. Special scientific societies were organized—Moscow Society of Eye Doctors, St. Petersburg Ophthalmological Society. In 1913, the I Congress of Russian Eye Doctors was held, attracting 250 participants and presenting significant scientific interest. Only the October Revolution unfolded before ophthalmology in the USSR the widest tasks, the fulfillment of which became the content of the work of ophthalmologists of the Union during the last decade. Soviet medicine put forward the slogan of ensuring the working population with specialized medical assistance, including ophthalmological.

Meanwhile, by the beginning of the World War, Russia had only about 300 specialist physicians for eye diseases, the vast majority of whom were concentrated in large cities. The ophthalmological clinics of medical faculties, institutes for the advanced training of physicians, and partly the eye hospitals that by that time existed not only in the capitals but also in some provincial areas, took on the responsibility of intensively training practical eye doctors needed to fill the positions of oculists in the newly opened large number of medical institutions in the regions (see Eye Diseases). The preventive orientation of Soviet medicine, in connection with the clearly recognized requirement of life to put science at the service of the proletariat, prompted a number of ophthalmologists to study professional hazards and industrial injuries in order to develop corresponding preventive measures (see Vision). The intensified care of the Soviet government for improving the living conditions of national minorities drew attention to the high incidence of eye diseases among them and led to special ophthalmological examinations to determine the extent of the problem and to develop measures for combating it. Along with carrying out these tasks, imperatively dictated by the needs of socialist construction, after a period of decline caused by the imperialist and civil wars, scientific work on various problems of theoretical and practical ophthalmology resumed and on a large scale. The quantitative growth of scientific institutions contributed significantly to the revitalization of this work. The number of ophthalmological clinics, due to the opening of new medical faculties and institutes, almost tripled. In addition, for the in-depth study of trachoma, which was very widespread within the USSR, its etiology, prevention and therapy, trachoma institutes were established in Kazan, Ufa, Saratov, while at the same time training doctors to work in areas predominantly affected by trachoma. In recent years, on the basis of two major eye hospitals—the Kharkov and the Leningrad named after Girshman—the Ukrainian State Institute of Theoretical and Practical Ophthalmology and the Leningrad Ophthalmological Scientific-Practical Institute have been opened with broad tasks for the comprehensive study of ophthalmological problems and the training of scientific and practical personnel in the field of ophthalmology. The scale of scientific research in ophthalmology can be partly judged by the large number of works published by Soviet ophthalmologists, not only within the USSR but also in the foreign periodical press. At present, within the USSR, two specialized journals on ophthalmology are published: 'Sovetskii Vestnik Oftalmologii' (formed in 1932 from the merger of 'Russkii Oftalmologicheskii Zhurnal', 1922-31, and 'Arkiv O.', 1925-31) and 'Ukrainskii Oftalmologicheskii Zhurnal' (since 1929). In 1926, the All-Union Congress of Eye Physicians was held in Moscow. It was followed by the All-Russian Congress in Leningrad (1928) and the Ukrainian Congress in Kharkov (1930), in addition to 3 regional North Caucasian ophthalmological congresses. Ophthalmological societies and circles have been formed and are functioning in almost all cities with medical institutes.

3. Frashg-Kamenetsky.