bluuebunny/crossref_metadata_2025 huggingface dataset:
Students' Perceptions of Nursing: Their Relationship to Attrition
Authors: Harvey Valerie C , McMurray Nancy E
Published: April 2021

ABSTRACT

This article describes a cross-sectional study that examined the effect of students' pre-enrollment perceptions of nursing education on attrition. It was hypothesized that more students who leave (leavers) than students who continue would report a discrepancy between these perceptions and their nursing academic experience. It was also hypothesized that leavers would rate several potential stressors as more important concerning decisions to leave than would continuers. The sample comprised students who commenced their nursing education at an Australian tertiary institution. As predicted, a greater percentage of leavers than continuers reported nursing content to differ from what they expected. The major area of conflict was the scientific component in nursing knowledge. The groups did not differ concerning potential stressors' influence on decisions to leave. While constrained by its cross-sectional nature, this study's findings suggest a need to adequately convey the scientific basis of nursing knowledge to potential students and to deal with misconceptions early in education, to reduce attrition.
Distance Learning and Nursing Education
Authors: Reinert Bonita R , Fryback Patricia B
Published: April 2021

ABSTRACT

This descriptive study investigated the use of distance learning programs in schools of nursing. Postcards were mailed to all members of the American Association of Colleges of Nursing, asking them about distance learning at their schools. Seven schools were selected for further interviews. Of the 353 schools (80%) that responded, 135 schools (38%) reported offering off-site courses. Forty-one schools reported plans for future offerings. The schools in this study offered a total of 33 master's and doctoral degrees by distance learning. A variety of media were used by the schools with the most common forms being one- and two-way video. Common themes identified from the interviews included faculty need for comfort, support, additional preparation time, and help developing courses. Student needs included structure, faculty contact, and a sense of belonging. The need for socialization was mentioned by all the informants.
Unity and Power: Lessons From Baccalaureate Entry
Authors: Wertz Eleanor , Rambur Betty
Published: April 2021

ABSTRACT

Education for nurses has been a contentious issue within and outside of the nursing profession since the American Nurses Association's 1965 support of the baccalaureate degree in nursing as basic educational criteria for the professional nurse (American Nurses Association, 1965). For 10 years, North Dakota has remained the only state to have achieved this educational goal, and North Dakota nurses have been able to defend this position against repeated challenges within the state since 1985. This article places nursing education within the context of the evolving, sweeping changes that are impacting all providers in the health care arena. The authors explain how and why North Dakota nurses were able to accomplish the standardization of nursing education for two levels of nurses: registered nurses and licensed practical nurses. The article describes the positive outcomes for nurses and clients that have occurred over the past 10 years.
Rhetoric to Practice: The Challenge of Collaboration of Academe and Industry
Authors: Mann Susan , Byrnes Tess , Power Charmaine , Clare Judith , Saint Kate , Rich Marian , Winifreyda Ailsa n'ha
Published: April 2021

ABSTRACT

Community health nursing is a complex practice that encompasses nurses working in many diverse settings. This article discusses the development of a project which focused on better preparation of students for potential employment in community settings. The formation of the working team and the development of the curriculum is outlined. A focus is given to the linking of primary health care principles in the teaching and facilitation of students within hospital and community setr tings. Comprehensive conclusions cannot be made yet from the project's preliminary findings. However, the process of collaboration has demonstrated several issues. These will have an impact on everyone who has been part of this project, and the issues are discussed in this article. The article provides an overview of the first year of collaboration of a 4-year project.
Transcending Behaviorism in Communication Education
Authors: Hartrick Gwen
Published: April 2021

ABSTRACT

During the past decade, nursing education has been engaged in a curriculum revolution. Although this ongoing revolution has led to profound changes in nursing curricula, one area that requires further scrutiny is communication education. This article addresses the limitations of behavioral communication curricula and suggests a pedagogical process responsive to the complexity of human caring relationships and the intricacies of relational practice. The discussion includes a description of a nursing communication course developed according to the principles of transformational learning theory.
Breaking Through the Hegemony of Homogeneity: Revitalizing Curriculum and Students
Authors: Mohr Wanda K , Naylor Mary D
Published: April 2021

ABSTRACT

Undergraduate programs provide fertile ground from which future practitioners, researchers, and teachers of psychiatric mental health nursing will emerge. Health care haa changed dramatically, offering opportunities for new and innovative roles and prompting faculty to develop novel ways of thinking about the future role of psychiatric nurses. Nursing faculty are challenged to devise new and creative approaches to teaching psychiatric nursing at the undergraduate level in ways that will instill enthusiasm for the ß eld. In this article, the efforts of the University of Pennsylvania to approach psychiatric mental health courses in new ways will be described. These innovations are designed to stimulate passion for what the authors see as a complex and exciting field that requires revitalisation.
A Comparison of Self-Reported Cultural Competency Skills Among Two Groups of Nursing Students: Implications for Nursing Education
Authors: Napholz Linda
Published: April 2021

ABSTRACT

This study was designed to examine self-reported cultural competency skills of second-semester junior-level nursing students toward clients from culturally diverse backgrounds. The purpose of this study was to ascertain if the addition of an innovative cultural sensitivity intervention facilitated greater self-perceived cultural competency skills when compared with the traditional method of incorporating cultural diversity into a junior-level clinical course. The Ethnic Competency Skills Assessment Inventory was used to collect data from participante attending a university in an urban midweetern county. Significant differences were noted between the pretest scores and posttest scores, Pretest scores were significantly lower than posttest scores for both groups. Nurse educators must examine further the differences in learning experiences related to cultural diversity that may account for these differences.
Peer Review of Teaching: Instituting a Program in a College of Nursing
Authors: Martsolf Donna S , Dieckman Barbara Cline , Cartechine Kathryn A , Starr Patricia J , Wolf Linda E , Anaya Ella R
Published: April 2021

ABSTRACT

Institutions of higher education can lose sight of the importance of teaching. Teaching, in some settings, needs to be restored to its place of primacy in the faculty role and ita quality needs to be evaluated. The American Association for Higher Education (AAHE) national project, "From Idea to Prototype: The Peer Review of Teaching,'' is an attempt to accomplish that purpose.

Involvement in the AAHE national peer review project has been the impetus for the Kent State University College of Nursing to initiate a faculty-developed program of peer review. The program has been well received primarily because it was owned and controlled by the faculty. Its voluntary nature, administrative sanction, and strong support have contributed to its success. Faculty explored many possible methods to accomplish peer review. However, the use of a task force, classroom and clinical observations, and teaching circles have been the approaches best suited to this particular departmental culture.
Bearing Witness to Suffering: The Lived Experience of Nursing Students
Authors: Eifried Sharon
Published: April 2021

ABSTRACT

This study explored the meanings of the lived experience of nursing students as they care for patients who are suffering. In this interpretive phenomenological study, 13 nursing students participated in conversational interviews and wrote narratives about their experiences of being with someone who was suffering. Embedded in the students' stories are the ways they came to understand suffering in the context of learning to practice nursing. The metatheme of bearing witness to suffering emerged from the analysis of the students' reflections. Bearing witness was exemplified with the subthemes of grappling with suffering, struggling with the ineffable, getting through, being with suffering patients, embodying the experience of suffering, and seeing possibilities in suffering. Bearing witness to suffering patients called students to an awareness of their own vulnerability. A concern for learning amid suffering was present throughout the students' texts. The call to care can be sustained through a pedagogy of suffering that acknowledges the need for support through a caring community.
An Education in Racism
Authors: Hassouneh-Phillips Dena , Beckett Ann
Published: April 2021

ABSTBACT

Lack of diversity in nursing doctoral programs compromises the quality of doctoral education and perpetuates the shortage of faculty of color in nursing schools. To help understand the contexts that contribute to this lack of diversity, this study examined the experiences of 9 women of color in nursing doctoral programs. The aim of the study was to describe the experiences, challenges, and understandings of women of color in nursing doctoral programs. Analysis of interview data revealed that racism was a pervasive and harmful influence on participants and that this influence was largely invisible to EuroAmerican faculty and students. These findings highlight the need for faculty and students to critically reflect on their own racism as an important first step in challenging the status quo of racism in nursing education.
"I Saw it in a Different Light": International Learning Experiences in Baccalaureate Nursing Education
Authors: Walsh Linda V , DeJoseph Jeanne
Published: April 2021

ABSTRACT

Health care providers in the United States are faced with delivering care to an increasingly diverse population. Nursing leaders and their respective organizations long have recognized the need to prepare nurses who understand the effects of the growing global community. Inclusion of cultural content in theory courses and clinical assignments in diverse settings are two ways to increase student nurses' cultural competency. This study explored the experiences of nursing students and faculty mentors who sought to increase their cultural competence through participation in a short-term immersion learning project in Central America. Analysis of data gathered through interviews and journal entries identified three themes - being "other," "I was already a nurse," and expanding my worldview.
Using Role Play to Develop Cultural Competence
Authors: Shearer Ruth , Davidhizar Ruth
Published: April 2021

ABSTRACT

Role play is a useful teaching strategy for nursing education. This strategy can simulate patient behaviors, as well as demonstrate nursing interventions that students must learn to be clinically competent. Role play is a dramatic technique that encourages participation to improvise behaviors that may be encountered in nurse-patient situations. Using this technique, participants may test behaviors and decisions in an experimental atmosphere without risk of negative effects in a relationship. Role play is useful in developing cultural competence because participants may experience diverse roles.

Cultural competence is the ability to care for patients in a culturally sensitive and appropriate manner. In role play, students may participate as culturally diverse patients or as nurses encountering patients from different cultures. Various teaching strategies facilitate successful use of role play in the classroom, including defining a time frame, selected roles, specific objectives, references, and grading criteria. Tb optimize learning, the importance of exploration and analysis must be emphasized. Many benefits and potential problems accompany use of role play.
Results of a National Survey Indicating Information Technology Skills Needed by Nurses at Time of Entry Into the Work Force
Authors: McCannon Melinda , O'Neal Pamela V
Published: April 2021

ABSTRACT

A national survey was conducted to determine the information technology skills nurse administrators consider critical for new nurses entering the work force. The sample consisted of 2,000 randomly selected members of the American Organization of Nurse Executives. Seven hundred fifty-two usable questionnaires were returned, for a response rate of 38%. The questionnaire used a 5-point Likert scale and consisted of 17 items that assessed various technology skills and demographic information. The questionnaire was developed and pilot tested with content experts to establish content validity. Descriptive analysis of the data revealed that using e-mail effectively, operating basic Windows applications, and searching databases were critical information technology skills. The most critical information technology skill involved knowing nursingspecific software, such as bedside charting and computeractivated medication dispensers. To effectively prepare nursing students with technology skills needed at the time of entry into practice, nursing faculty need to incorporate information technology skills into undergraduate nursing curricula.
Education for Differentiated Role Development for NP and CNS Practice: One Nursing Program's Approach
Authors: Plager Karen A , Conger Margaret M , Craig Carol
Published: April 2021

ABSTRACT

Development of nurse care providers who best meet the public's health care needs is imperative. Some nurses believe the functions of nurse practitioners and clinical nurse specialists should be combined. However, the experience of the authors' nursing program argues otherwise. Two graduate nursing tracks, family nurse practitioner and rural health specialist, were developed to meet the health care needs of rural populations. Although the two tracks share expected competencies and areas of expertise to some extent, differences in practice are apparent in identified domains of practice and terminal competencies. Family nurse practitioner practice focuses on assessment, diagnosis, and management of health and illness conditions of individuals and families across the Ufe span. Clinical nurse specialist practice incorporates traditional roles of client assessment, monitoring and coordination of care, outcome assessment, and client, family, and community education, with a new focus on case management strategies. These differences are important to care delivery in the managed care era.
Varying Esotropia-Exotropia
Authors: Metz Henry S , Sterns Gwen
Published: April 2021

ABSTRACT

A 20-year old female was found to have an alternating pattern of right esotropia and right exotropia following surgery for a clivus chordoma three years previously. When esotropic, abduction was markedly limited while adduction was full in the right eye. When exotropic, mild limitation of both abduction and adduction was noted.

Horizontal saccadic velocity studies were consistent with the diagnosis of sixth nerve palsy when esotropia was manifest and a Duane's syndrome, type II when exotropia was present.

The etiology of these unusual findings is not well understood.
Habitual Head Turning in Spasmus Nutans: An Oculographic Study
Authors: Chrousos Georgia Antonakou , Reingold Douglas R , Chu Fred C , Cogan David G
Published: April 2021

ABSTRACT

Head turning in patients with spasmus nutans seems to transiently dampen the nystagmus. This was evident in two children by clinical observation and electrooculographic recording. The suppression of the nystagmus may have been mediated by the vestibular system.
Weill-Marchesani Syndrome With Bilateral Angle-Closure Glaucoma
Authors: Wright Kenneth W , Chrousos Georgia Antonakou
Published: April 2021

ABSTRACT

To our knowledge this is the first reported case of cyclopentolate induced bilateral acute angle-closure glaucoma associated with the Weill-Marchesani syndrome without lens subluxation. The diagnosis of Weill-Marchesani syndrome was not initially suspected, and Pilocarpine was used in an attempt to break the acute attack. Treatment with Pilocarpine-induced myosis only worsened the glaucoma by causing a severe pupillary block. This case is important because it demonstrates that mid-dilatation and cycloplegia can induce acute glaucoma in patients with the Weill-Marchesani syndrome and points out the importance for considering the diagnosis of Weill-Marchesani syndrome in any case of acute glaucoma in childhood.
Glycoconjugates, Cellular Differentiation, and Congenital Glaucoma
Authors: Beauchamp George R , Lubeck David , Knepper Paul L
Published: April 2021

ABSTRACT

Studies of congenital glaucoma have described and debated the disease process in cellular and structural terms, yet the functional aspects of the disease remain poorly understood. This paper presents an attempt to look at the disease from a different perspective: the role of glycoconjugates and their influence on morphogenesis of the corneoscleral angle. Extracellular and cell-surface complex carbohydrates and trabecular meshwork development were observed in normal C-57 BL/6J mice with light and electron microscopy. Lectin-stained fixed tissues were evaluated by fluorescein light microscopy and with computercontrolled scanning microspectrophotometry. The appearance and type of specific glycoconjugates was related to morphogenesis and differentiation, with specific reference to the development of the trabecular meshwork.

Our results suggest that glycoconjugates are: (1) important in the morphogenesis of the corneoscleral angle, and (2) provide some of the required signals for the differentiation of the cells of the trabecular meshwork. These findings emphasize the possibility that a complex series of morphological and biological events in the normal development of the trabecular meshwork ultimately leads to a functionally competent trabecular meshwork, that is, capaci tation.
Superior Oblique and Inferior Rectus Muscle Injury Following Frontal and Intranasal Sinus Surgery
Authors: Rosenbaum Arthur L , Astle Willinm F
Published: April 2021

ABSTRACT

Chronic inflammatory sinus disease is a common process, sometimes requiring nasal and paranasal sinus surgery. Extraocular muscle dysfunction is a rare surgical complication of sinus surgery, but has been reported. Previous studies have been concerned with trauma to the medial rectus muscle resulting in severe paralysis or restriction.

This study reports five patients with acquired strabismus and symptomatic vertical diplopia secondary to sinus surgery. In all patients, the resultant diplopia was disabling. Four patients had frontal sinus window surgery performed, with incisions placed in the supero-nasal quadrant of the orbit, below the eyebrow (a modified Lynch incision). Three patients acquired a superior oblique paresis and the fourth developed a Brown's syndrome. The location of the skin incision was critical to injury in the trochlear area. The fifth patient underwent a nasal polypectomy and antrostomy with secondary orbital hemorrhage and proptosis. A mild inferior rectus paresis was the result.
Amblyopia Case Reports - Bilateral Hypermetropic Ametropic Amblyopia
Authors: Werner David B , Scott William E
Published: April 2021

ABSTRACT

Six patients are presented with ametropic amblyopia secondary to bilateral hypermetropia. Two patients had a strabismic amblyopia superimposed upon the ametropic amblyopia. All patients had a marked improvement in their visual acuity with the use of constant glass wear only No associated ocular pathology was identified. It is the authors' belief that these patients are seen occasionally in general ophthalmologic practice. The diagnosis and treatment is straightforward; however, the diagnosis can be perplexing and unnecessary referrals and neuro-ophthalmologic investigation can ensue if this entity is not recognized.
The Management of Esotropia With High AC/A Ratio (Convergence Excess)
Authors: Pratt-Johnson J A , Tillson G
Published: April 2021

ABSTRACT

This paper reviews the long-term follow-up of esotropia with a high AC/A ratio defined as an increase of 20Δ or more of the esotropia at near compared with distance with the full optical correction of any refractive error in place.

Ninety-nine patients were studied for an average followup of eight years. Eighty-six achieved fusion but only five achieved central fusion. Forty-five were treated with bifocals. No significant difference in the sensory results were recorded in those patients wearing bifocals compared with those who did not wear bifocals. No patient had miotic therapy for more than a few months. The suppression characteristic of this condition is reviewed.
Endophthalmitis due to Salmonella typhimurium
Authors: Appel I , Landman I , Savir H , Elian E
Published: April 2021

ABSTRACT

A 1-year-old female patient is described who suffered from sepsis and endophthalmitis due to Salmonella typhimurium. This Salmonella species rarely causes septicemic syndrome or focal infection of body organs. As far as we know this is the first case report of endophthalmitis caused by S typhimurium despite its high frequency among Salmonella infections not caused by S typhi.
Clinical Features of Duane's Syndrome
Authors: Raab Edward L
Published: April 2021

ABSTRACT

This report describes the clinical findings in 70 cases of Duane's retraction syndrome. There were 25 (36%) affected males and 45 (64%) females. Left eye preponderance (67%) was observed and seven (10%) were bilateral. Type 1 cases were the most common (73%), and bilateral cases often were of different types. The features studied were primary position deviation, face turn, anomalous vertical movements, divergence in midline vertical gaze, anisometropia, and amblyopia. Horizontal saccadic velocities in ten patients were confirmatory. The significance of head positions and distance/near alignment comparisons, and the role of case classification and saccadic velocity determination are discussed.
The Use of Magnetic Resonance Imaging in the Evaluation of Retinoblastoma
Authors: Schulman Joel A , Peyman Gholam A , Mafee Mahmood F , Lawrence Linda , Bauman Alan E , Goldman Arnold , Kurwa Badrudin
Published: April 2021

ABSTRACT

We examined a 4-year-old boy who had a painful blind eye, rubeosis iridis, and leukokoria. Ultrasonography and computed tomography (CT) detected intraocular calcification and other features suggestive of retinoblastoma. The CT scan showed extraocular extension along the optic nerve. Intracranial extension of the tumor could not be definitely excluded by CT scan with intrathecal metrizamide infusion. Magnetic resonance imaging (MRI) and CT performed after radiation and chemotherapy were useful in excluding intracranial spread of malignant cells, thereby aiding the selection of a surgical approach to ensure complete removal of the involved portion of the optic nerve.
Retinoblastoma: Correlation Between Age at Diagnosis and Survival
Authors: Abramson David H , Ellsworth Robert M , Grumbach Nicholas , Sturgis-Buckhout Lee , Haik Barrett G
Published: April 2021

ABSTRACT

Life tables analyses were performed from the records of 1147 patients seen between 1958 and 1983 to determine correlation between age at diagnosis and survival from metastatic retinoblastoma. No difference was noted overall in survival from metastatic retinoblastoma for unilateral vs. bilateral, male vs female, or family history vs negative family history. Survival rate of 21 of 40 patients diagnosed after age 7 and receiving no treatment was 96%. Two patients in this group did develop metastasis: one because of late diagnosis and one because treatment was refused. One patient with an "arrested retinoblastoma" showed growth in his third decade, necessitating treatment.

Survival was poorest in patients diagnosed between ages two and seven years where mortality was 19% from metastatic retinoblastoma. Patients diagnosed between birth and two years had an intermediate survival of 95%. Because of second nonocular tumors, survival of the patient with unilateral retinoblastoma was significantly better than that of the bilaterally affected child.
Up- and Downshoot in Duane's Retraction Syndrome
Authors: von Noorden Gunter K , Murray Elizabeth
Published: April 2021

ABSTRACT

Up- and downshoot of the adducted eye in patients with Duane's retraction syndrome was surgically eliminated in five patients by posterior fixation of the horizontal rectus muscles. Retroequatorial fixation of these muscles reduces sideslip and thus a vertical effect of the co-contracting horizontal rectus muscles.
Treatment of Facial Spasm With Oculinum (C. Botulinum Toxin)
Authors: Biglan Albert W , May Mark
Published: April 2021

ABSTRACT

Forty-six consecutive adult patients with facial spasm were treated with one or more Botulinum toxin (Oculinum) injections to control muscle spasm. During the follow-up period of 6.6 months (one week-12 months), 27 patients required retreatment with a mean time interval of 3.4 months between treatments. Control of facial spasm was achieved in all patients. Complications included occasional bruising around the injection site and a transient blepharoptosis in one patient. No systemic effect was observed. This preliminary report suggests that treatment with Botulinum toxin (Oculinum) is an acceptable alternative to surgical management in select patients.
Transection of the Inferior Rectus Muscle
Authors: Cronin Cathleen M , Mittelman David , Folk Eugene R , Moore Dorothy
Published: April 2021

ABSTRACT

Four cases of isolated inferior rectus transection secondary to trauma are presented. The clinical and CT scan findings are illustrated. The CT scan findings are very useful in the surgical management and prognosis of these cases.
The Effect of Oblique Muscle Surgery on the Axis of Astigmatism
Authors: Kushner Burton J
Published: April 2021

ABSTRACT

A series of 22 highly astigmatic eyes in 14 patients underwent surgery, either in the form of recessing the inferior oblique, tenotomizing the superior oblique, or tightening the superior oblique. The refractive errors obtained in a masked manner six months postoperative were compared to those preoperative. Weakening the inferior oblique or tightening the superior oblique produced a long-term incyclorotation (clockwise for right eyes and counterclockwise for left eyes) of the axis of astigmatism of approximately 10 degrees. Tenotomizing the superior oblique produced a long-term excyclorotation (counterclockwise for right eyes and clockwise for left eyes) of the axis of astigmatism of about 10 degrees.
An Alternative Hypothesis for Iris Maldevelopment (Aniridia)
Authors: Beauchamp George R , Meisler David M
Published: April 2021

ABSTRACT

Two principal hypotheses for the pathogenesis of hypoplastic iris development ("aniridia") have been proposed: 1) the ectodermal theory, positing incomplete elaboration of the cup, resulting in an absence of framework for further development; and 2) the "mesodermal" theory ,wherein inadequate migration or proliferation of mesenchymal elements is proposed.

Two eyes of two patients with persistent "anterior leaf' iris strand remnants which traverse the pupillary space are reported. They are differentiated from the previously described persistent tunica vasculosa lentis.

The presence of a persistent pupillary iris strand suggests portions of the iris may have formed and inappropriately regressed. Recent work in cell biology highlights the importance of remodeling and cell death in revealing ultimate phenotypic expression. This alternative hypothesis suggests that aniridia may be explained in part on the basis of excessive remodeling and cell death.
Acute Orbital Pseudotumor With Iatrogenic Intraorbital Air: A Diagnostic Dilemma
Authors: Wagner Alan L , Crouch Earl R , Valone James A
Published: April 2021

ABSTRACT

A 13-year-old black female was referred with unilateral granulomatous uveitis and orbital inflammation of sudden onset. Hematologic, serologic, bacteriologic, and ultrasonographic studies along with high resolution CT scans of the orbits were employed to determine the diagnosis and appropriate treatment. Subconjunctival corticosteroid injection containing air prior to referral obfuscated the ultimate diagnosis of pseudotumor. The Pediatric Infectious Disease service delayed definitive treatment with systemic steroids. Differential diagnosis of granulomatous uveitis with orbital inflammation are discussed. CT scan has significantly advanced the diagnosis and management of orbital pseudotumor.
Excision of Individual Follicles for the Management of Congenital Distichiasis and Localized Trichiasis
Authors: Wolfley Darrell
Published: April 2021

ABSTRACT

This paper presents a brief review of the literature regarding congenital distichiasis. The literature is confusing regarding the term distichiasis. Distichiasis should be utilized to describe congenital partial or complete accessory rows of eyelashes which exit from the posterior lid margin behind the meibomian gland orifices. The term acquired trichiasis and congenital distichiasis are significantly different.

This paper also describes a new method for microscopically dissecting and excising the follicles of distichiatic eyelashes. The technical details of the surgical procedure are described with appropriate illustrations. This procedure can also be utilized for removal of localized areas of acquired trichiasis.

The advantage of this procedure over previously utilized procedures for congenital distichiasis is the lower incidence of recurrent distichiatic lashes, combined with complete preservation of normal eyelashes and essentially no risk of cicatricial entropion following this procedure.
Accommodation in Hyperopic and Myopic School Children
Authors: Mäntyjärvi Maija I
Published: April 2021

ABSTRACT

Binocular accommodation of 150 consecutive hyperopic and 150 myopic school children was measured during the eye examination. There were 99 girls and 51 boys in the hyperopic group and 100 girls and 50 boys in the myopic group. The ages varied from seven to 16 years. Accommodation of the hyperopic children varied from 4 to 20 D (mean 10.6 ± 3.4), and in the myopic children also from 4 to 20 D (mean 10.9 ± 2.5). The difference between these means was not statistically significant. However, hyperopic girls aged 12 to 16 years showed low values of accommodation (mean 9.0 ± 2.7) compared to the other corresponding age groups. In the second part of the study the refraction of 80 children, aged seven to 15 years, with decreased accommodation was studied retrospectively to see if they had a tendency to become myopic. The follow-up time was from one to eight years, and the accommodation at the beginning of the observation time varied from 2 to 7 D. The mean annual change of the refraction of these children was from - 0.03 to - 0.17 D. In 34 children there was no change at all, and in 12 children the change of refraction was slightly toward more hyperopia. Only three of these 80 children became myopic during the observation time. This incidence is lower than the incidence of myopia at these ages. Thus, accommodative power of hyperopic and myopic school children appears to be on the same level, and low accommodation does not predict the development of myopic refraction in the school years.
Operant Acuity of Toddlers and Developmentally Delayed Children With Low Vision
Authors: Birch Eileen , Hale Linda , Stager David , Fuller Dwain , Birch David
Published: April 2021

ABSTRACT

The present report describes an operant procedure for the assessment of grating acuity in young and/or developmentally delayed children. Prior to testing, the child was trained to point to a grating presented on one of two equally bright screens. A reward was given to the child for each correct response. During the test, the gratings became progressively finer until the child no longer made consistently correct choices. Normative data from 90 children show improvement in grating acuity during years one to five (from 20/50 to 20/17). Results were also obtained from 100 consecutive pediatric patients who were thought to be visually unresponsive or visually impaired by the referring ophthalmologist. Overall, 12% of these children tested within the normal range, 53% had grating acuities better than 20/200 but below normal, 27% had acuities below 20/200, and 8% were not measurable. These results suggest that a wide range of visual potential exists in this population and that some of these children may benefit from visual aids and training.
Bilateral Hypermetropic Amblyopia
Authors: Schoenleber Dana B , Crouch Earl R
Published: April 2021

ABSTRACT

A retrospective analysis was performed on the records of 184 children who had hyperopia of at least 4.0 diopters in each eye to see if bilateral amblyopia was more than just a rare occurrence and to evaluate how well it responded to treatment. Twelve patients were found to have bilateral amblyopia of 20/50 or worse. The mean age at diagnosis was four and a half years (two and a half to six and a half) and mean follow-up was 22 months (five months to seven years, four months). Ten of 12 patients showed improvement of vision to 20/40 or better in both eyes. Treatment consisted of full cycloplegic correction in all cases. Six patients had accommodative esotropia but this did not account for the bilateral nature of the amblyopia.

Bilateral amblyopia should be considered in patients with large amounts of hyperopia. It responds well to treatment with standard amblyopia therapy.
Prevention of Strabismic Amblyopia of Early Onset With Special Reference to the Optimal Age for Screening
Authors: Neumann E , Friedman Z , Abel-Peleg B
Published: April 2021

ABSTRACT

Of 78 consecutive cases with constant unilateral esotropia diagnosed during screening and treated from the ages of seven months to three years, 82% ended up with visual acuity of 6/12 or better toward end of active treatment at the age of six to eight years. Of the cases with visual acuity of 6/12 or better at the end of treatment, 59% retained their vision when re-examined four to ten years later. The most important single parameter for the achievement of normal visual acuity was age of onset of treatment below two years and for long-term stability of the result this age dropped to 18 months. Initial large angles of esotropia had better prognosis probably because they were associated with an earlier onset of treatment.

Poor prognosis was associated with faulty or no fixation of the esotropic eye when first diagnosed, with the failure to achieve alternation and with marked ansiometry.

The optimal age for screening for strabismic amblyopia was suggested to be 12-18 months.
Theoretical Effects of Surgery on Length Tension Relationships in Extraocular Muscles
Authors: Kushner Burton J , Vrabec Michael
Published: April 2021

ABSTRACT

The main effect of recession or resection of a rectus muscle is thought to be due to an alteration of its length-tension curve (Starlings Law). Because the subsequent straightening of the eye produces a movement of the new insertions of the rectus muscles either anteriorly or posteriorly in the orbit, the actual amount of tightening or shortening of the muscle is not equal to the amount of recession or resection. How much this phenonmenon alters the true amount of tightening or shortening of a muscle has important implications in the determination of safe amounts of surgery, which may differ if one is operating on the fixing or non-fixing eye. In addition, the size of the globe should have an important role in determing the response per millimeter of surgery.
Results of Early Treatment of Unilateral Congenital Cataracts
Authors: Robb Richard M , Mayer D Luisa , Moore Bruce D
Published: April 2021

ABSTRACT

Twelve infants with unilateral congenital cataracts treated at Boston Children's Hospital between 1978 and 1986 have now reached the age of 3.5 years or older. All infants had cataract extractions, aphakic contact lens fitting, and occlusion of the unaffected eye by 6 months of age. Patients with posterior lenticonus or persistent hyperplastic primary vitreous were excluded from this review. Early improvement of visual acuity in the aphakic eye was monitored by preferential looking tests, and occlusion of the sound eye was adjusted accordingly. E card visual acuities are now available on all 12 children. Five patients have 20/70 or better visual acuity, three patients have between 20/100 and 20/400 vision, and four patients have less than 20/400 in the aphakic eye. Two patients whose cataract surgery was done after 4 months of age had the poorest visual results. Difficulty maintaining occlusion therapy and interruptions of contact lens wear limited the development of better vision in some patients. The visual results to date in these 12 patients suggest that early aggressive treatment of unilateral congenital cataracts is worthy of consideration in most instances.
Superior Oblique Overaction in Patients With True Brown's Syndrome
Authors: Sato Sam E , Ellis Forrest D , Pinchoff Barry S , Helveston Eugene M , Rummel John H
Published: April 2021

ABSTRACT

The charts of all patients with the diagnosis of congenital Brown's syndrome seen between July 1983 and June 1984 were examined retrospectively. In the past, overaction of the ipsilateral superior oblique (OAISO) was felt by most authors to be absent or minimal. Our study revealed that separate observers consistently documented the presence of an OAISO in about one-fifth of the selected patients. The presence of OAISO has not been emphasized previously and still remains controversial. We felt that an extremely tight superior oblique might cause an OAISO. We therefore statistically compared its presence to the presence of a downshoot. The presence of an OAISO to abnormal head tilt, abnormal chin position, amblyopia, and abnormal stereo was also compared statistically. Finally, we emphasize a technique of forced ductions that differentiates Brown's syndrome from an inferior oblique palsy, but which also alerts the examiner to the presence of an inferior rectus restriction or other posteriorly located restrictions.
Post-Radiation Retinal Infiltrates Simulating Recurrent Retinoblastoma: A Clinical and Pathologic Case Report
Authors: Judisch G Frank , Folberg Robert
Published: April 2021

ABSTRACT

An 8-month-old boy was found to have a sporadic unilateral stage IIa retinoblastoma, extending inferiorly and temporally from the right fovea. Within 5 weeks of diagnosis the tumor was treated with 4500 rads fractionated over 20 treatments. Examination under anesthesia (EUA) 1 month later revealed unequivocal clinical and echographic evidence of tumor regression. EUA 3 months after completion of radiation therapy revealed continued tumor regression with no evidence of new tumor formation. The third EUA, performed 6 months after radiation treatment, showed that multiple discreet gray-white retinal infiltrates had developed, predominantly in the area immediately below the regressed tumor. Because of concern that these lesions represented viable retinoblastoma, the eye was enucleated. Pathologic examination of these lesions revealed them to be collections of foamy cells containing melanin granules suggestive of pigment epithelial origin.
Optic Nerve Shadow Enlargement in the Klippel-Trenaunay-Weber Syndrome
Authors: Good William V , Hoyt Creig S
Published: April 2021

ABSTRACT

A 10-year-old girl with Klippel-Trenaunay-Weber syndrome (KTWS) showed neuroradiology signs of enlarged optic nerve and medial rectus shadows. In 3 years of follow-up, her vision has remained normal. This is the first report of optic nerve enlargement in this syndrome. The case demonstrates that enlargement of the optic nerve shadows is not inevitably associated with visual deterioration. Optic nerve enlargement may be part of a hamartomatous process that involves other orbital contents.
Visual Acuity Measurements by Swept Spatial Frequency Visual-Evoked-Cortical Potentials (VECPs): Clinical Application in Children with Various Visual Disorders
Authors: Gottlob Irene , Fendick Michael G , Guo Suqin , Zubcov Alina A , Odom J Vernon , Reinecke Robert D
Published: April 2021

ABSTRACT

Previous studies have indicated that visual acuities of normal infants can be estimated with good accuracy using swept spatial frequency visual-evoked-potentials (VECPs). In this report we describe acuity measurements obtained with this technique from 304 examinations performed on 135 children having various visual disorders. When possible, two or more different stimulation frequencies (8, 12, 15 or 24 contrast reversals/sec) were used in each patient, and three to eight sweep VECPs were obtained from each patient under each simulation and recording condition. High correlation coefficients (0.94 - 0.96) between the acuity estimated on each patient from either the single sweep giving the best visual acuity (BSS) or from vector averages (VeA) of the EEG data obtained from several sweeps confirmed previous findings in normal infants. We also found high correlation coefficients among BSS recorded at different temporal frequencies (0.79 - 0.97) and among comparisons of BSS or VeA acuity to optotype visual acuity (0.6 - 0.89). Children with clinically undetectable optokinetic responses showed lower visual acuity estimated by BSS than those who demonstrated optokinetic nystagmus. We conclude that the sweep VECP is a valid method, giving estimates of acuity which correlate well with optotype acuity and correspond well to other clinical findings, and that it can be useful in the clinical management of nonverbal patients.
Asymmetric Horizontal Tropias, DVD, and Manifest Latent Nystagmus: An Explanation of Dissociated Horizontal Deviation/Discussion: Asymmetric Horizontal Tropias, DVD, and Manifest Latent Nystagmus
Authors: Zubcov Alina A , Reinecke Robert D , Calhoun Joseph H
Published: April 2021

ABSTRACT

Four patients with dissociated horizontal deviation (DHD) are described and an explanation of their horizontal comitant deviations is offered. The patients had asymmetric comitant horizontal deviations dependent on the fixing eye. All of them had unequal visual acuity (VA) and asymmetric manifest latent nystagmus (MLN) documented with eye movement recordings. The subjects appear to use convergence to reduce their nystagmus when viewing with the eye having more severe nystagmus and hence poorer vision. When patients viewed with the eye having less nystagmus, little or no convergence was exhibited. We suggest that DHD may be the manifestation of an asymmetric nystagmus blockage syndrome (NBS). The dampening effect of convergence on nystagmus has been well documented in the past and seems to apply here. The patients demonstrate that a true, but asymmetric NBS, can be found with MLN.
Long-Term Follow-up of Candida Endophthalmitis in the Premature Infant
Authors: Annable William L , Kachmer Mary Lou , DiMarco Marianne , DeSantis Diana
Published: April 2021

ABSTRACT

In the March 1981 issue of the Journal of Pediatrics, Baley, Annable and Kleigman discussed the natural course of Candida endophthalmitis in the premature infant. We now have long-term follow-up on the three surviving infants along with follow-up on an additional eight patients. Though vitrectomy is routinely performed in adults, we recommended that it not be performed in premature infants with systemic candidiasis and associated vitreo-retinal pathology. These 1 1 infants with candidal endophthalmitis secondary to systemic candidiasis demonstrated minimal residual ocular pathology after having been treated with systemic antifungals alone. Neither vitreous taps nor intravitreal injections should be performed in infants with ocular candidiasis.
Subconjunctival Steroid in the Management of Uveal Juvenile Xanthogranuloma: A Case Report
Authors: Treacy Kevin W , Letson Robert D , Summers C Gail
Published: April 2021

ABSTRACT

Uveal juvenile xanthogranuloma (JXG) is a rare intraocular tumor which usually occurs in very young children. Most reported cases of successfully treated uveal juvenile xanthogranuloma have received systemic steroids, irradiation or excision. Some cases have responded to topical steroids alone. We report a case of JXG with recurrent hyphemas and elevated intraocular pressures despite the use of topical steroid. This patient responded to the addition of subconjunctival steroid injection. This is the first report to our knowledge demonstrating a response to periocular steroid supplementation for uveal JXG unresponsive to topical steroids.
Complete Cryptophthalmos: Case Report With Normal Flash-VEP and ERG
Authors: Hing S , Wilson-Holt N , Kriss A , Flüeler U , Taylor D
Published: April 2021

ABSTRACT

We report an infant with bilateral compiete cryptophthalmos as part of Fraser Syndrome. Clinical examination and recordings of the electroretinogram and flash visual evoked potential showed a functional visual pathway at retinal and post-retinal levels. Anatomical considerations and the possible complications of surgery made reconstruction of the lids and palpebral fissures inappropriate.
Assessment of Visual Acuity in Children With Severe Neurological Impairments
Authors: Adams Russell J , Courage Mary L
Published: April 2021

ABSTRACT

We used the Teller Acuity Cards to assess visual acuity in children with severe neurological handicaps (N = 12), all of whom had been previously untestable. With every child we were able to obtain at least one estimate of visual acuity, even with those described as likely having little or no visual function. However, in all cases, performance was poorer than that of unimpaired children of the same age. Our results confirm that the test is useful for assessing visual acuity in populations who, because of significant cognitive, linguistic, and motor deficits, cannot be assessed by more traditional techniques.
Pars Plicata Lensectomy/Vitrectomy for Developmental Cataract Extraction: Surgical Results
Authors: Green Beth F , Morin J Donald , Brent Henry P
Published: April 2021

ABSTRACT

Fifty-two cases of developmental cataracts extracted using the pars plicata lensectomy/vitrectomy technique were reviewed. Eyes with additional ocular anomaly other than microphthalmos were not included. No early complications were detected in a postoperative period ranging from 1.5 to 7 years with a median of 4 years, and late complications were limited to secondary membranes occurring in small eyes. Since secondary membranes occurred only in eyes in which the axial length was ≤ 17.4 mm and the corneal diameter was ≤ 9.5 mm, we suggest that eyes that are small by the absolute dimensions cited here are at greater risk of developing secondary membranes postoperatively. Small eyes by absolute dimensions should be distinguished from microphthalmia eyes, since the relative term microphthalmia is less predictive of risk of complication than are absolute dimensions.

Linear Snellen acuity in 15 patients capable of response ranged as follows: 20/20-20/80 with a median of 20/40 in eyes with partial bilateral cataracts; 20/25-20/80 with a median of 20/50 in eyes with complete bilateral cataracts; 20/30-20/400 with a median of 20/200 in eyes with unilateral partial cataracts; and 20/60-CF with a median of 20/400 in eyes with complete unilateral cataracts. Mean patient ages at surgery were 3 months for those with bilateral complete cataracts, 5 months for those with unilateral complete cataracts, 18 months for those with bilateral partial cataracts, and 25 months for those with unilateral partial cataracts. The earliest possible removal of visually significant opacities must be combined with aggressive postoperative visual rehabilitation to obtain the best possible visual outcome.