bluuebunny/crossref_metadata_2025 huggingface dataset:
Introducing a Feminist Perspective to Nursing Curricula: A Quantitative Study
Authors: Boughn Susan , Wang Henry
Published: April 2021

ABSTRACT

Feminist concerns of the nursing profession are examined and it is argued that feminism provides the ideology and impetus for social change. The purpose of this study is to investigate the effects on the attitudes and beliefs of nursing students who take a feminist-oriented women's health course. The course went beyond a scientific model of women's health and examined women's health issues as they are related to the concerns of women as consumers and providers. A questionnaire assessing the effects of the course was administered at the beginning and again at the end of the course. Results indicated that the course produced significant changes in the attitudes and beliefs of the experimental subjects in areas of professional activism; high regard for self, nurses, and women; and social activism against sexism in the media and violence against women.
Integrating Nursing Research Findings into the Curriculum: A Descriptive Study
Authors: Herbener Debra J
Published: April 2021

ABSTRACT

This descriptive study examined methods used to integrate nursing research findings into associate, baccalaureate, and master's nursing program curricula. Nursing faculty members (N = 420) from 105 programs in the NLN's North Atlantic region were asked, in a mailed survey, to indicate the course objectives and learning activities concerning nursing research findings used in their courses. Completed surveys were returned from 55% (n = 231). Chi-square analyses showed significant differences in all course objectives and most learning activities among faculty. Faculty in baccalaureate and/or master's programs used the objectives and most learning activities concerning nursing research findings more than faculty from the associate degree programs. Overall, however, faculty have made concerted efforts to teach nursing research findings using a variety of course objectives and learning activities. Further research is recommended to determine the most effective strategies. Educators are encouraged to provide opportunities for students to use accepted research findings in practice.
Perceptions of Effective Clinical Teachers in Associate Degree Programs
Authors: Sieh Selina , Bell Shirley K
Published: April 2021

ABSTRACT

This study examined students' and faculty's perceptions of important characteristics of associate degree clinical teachers. Differences in perceptions were compared. Perceptions were measured using the Nursing Clinical Teacher Effectiveness Inventory. Associate degree nursing students (N= 199) and faculty (N = 22) from two southwestern community colleges participated in the study. All 48 items were rated highly by both students and faculty, ranging from 3.86 for "Directs students to useful literature in nursing* to 4.85 for "Corrects students' mistakes without belittling them." Students' and faculty's perceptions of important characteristics of effective clinical teachers by subsets were not significantly different. Since few studies on students' and faculty's perceptions have been done at the associate degree level, the results were comparable except for the item "good role modeling," which was not rated as highly in this study as in previous studies of baccalaureate students.
Education for Clinical Practice: An Alternative Approach
Authors: Packer Janette L
Published: April 2021

ABSTRACT

Although there have been many advances in technology, nursing science, and the professional role, there has been little planned, substantive change in the approach to clinical education. Documented problems include faculty workload, clinical placements, student anxiety, and concurrent teaching and evaluation. This article reviews the current status of clinical education and offers an alternative approach. The recommendation involves teaching a course on clinical practice, which includes patient care and adaptive competencies, evaluation in the college laboratory, and placing students with preceptors in the clinical laboratory. Ideas for implementation are offered, which include curricular changes and student-centered teaching strategies that encourage activities such as reflection and decision making. Advantages include opportunities for professional development for faculty and preceptors, improved student learning, and elimination of reality shock. The need for faculty development and educational research is emphasized.
Evaluation of Nursing Faculty Through Observation
Authors: Crawford Lynda H
Published: April 2021

ABSTRACT

The purpose of this study was to assess current use and faculty perceptions of classroom observation as a method of faculty evaluation in schools of nursing. Baccalaureate schools of nursing were surveyed to determine current use of classroom observation and its worth from the perception of administrators and faculty. Although most schools used classroom observation as a method of faculty evaluation, further clarification and research is needed in the following areas: purpose of classroom observation; number of observations necessary; weight given to classroom observation in relation to other evaluation methods; and tools used.
Curriculum Revision: Reaching Faculty Consensus Through the Nominal Group Technique
Authors: Davis Debra C , Rhodes Rosemary , Baker Amanda S
Published: April 2021

ABSTRACT

A fundamental concept to initiate change in the curriculum revision process is to overcome résistance to change and the boundaries of self-interest. Curriculum change cannot occur without an "unfreezing" of faculty values and interests. The Nominal Group Technique (NGT) was used to facilitate faculty identification of areas needing change in the undergraduate nursing curriculum. The process led to the generation of numerous independent ideas in which all faculty participated. The revised curriculum which resulted from the NGT process has had full and enthusiastic support of the faculty.
Teaching Using Interactive Video: Creating Connections
Authors: Chandler Genevieve E , Hanrahan Patricia
Published: April 2021

ABSTRACT

This article addresses the two essential elements of distance learning: the technology and the pedagogy. Both areas are discussed through the four components-information, support, resources, and relationships-of a work effectiveness model. Drawing from recent literature and their experience, the authors offer strategies for making interactive video technology "invisible" while engaging students at a distance. Students experience connections when faculty know how to manage the equipment, plan ahead, and consciously construct strategies for creating relationships across the miles.
Students' Perceptions of Field Experience Professional Development: A Comparative Study
Authors: Dunn Sandra V , Ehrich Lisa , Mylonas Alissa , Hansford Brian C
Published: April 2021

ABSTRACT

The movement of the health care and education professions from an apprenticeship model in the early half of the century to the tertiary education sector has brought an awareness of the key role field experience or practicum plays in professional development. The literature has demonstrated that field experience during teacher education and clinical education is a valuable part of preparation for entry into the teaching and nursing professions. The purpose of this study was to compare and contrast the perceptions of final year students from three distinct undergraduate field experiences. Queensland University of Technology students from adult and workplace education, secondary education, and nursing participated in the study. Data were collected through a series of focus group interviews with groups of five to nine participants across the three discipline areas. Students described their expectations of the practical side of their learning and the learning outcomes that eventuated during the practicum.
Reflective Practice: A Critical Analysis of Data-Based Studies and Implications for Nursing Education
Authors: Ruth-Sahd Lisa A
Published: April 2021

ABSTRACT

Reflective practice has become part of the discourse of nursing education classrooms, conferences, and journals, and are popular features of nursing continuing education programs. Yet, the idea of reflective practice has become increasingly more disparate. This critical analysis examines data-based studies and provides an overview of reflective practice, discusses common themes that emerged from the studies, and identifies implications for reflective practice in the field of nursing education.
Sponsored Professional Seminars: Enhancing Professionalism Among Baccalaureate Nursing Students
Authors: Brockopp Dorothy , Schooler Mary , Welsh Darlene , Cassidy Karma , Ryan Patricia Y , Mueggenberg Kay , Chlebowy Diane Orr
Published: April 2021

ABSTRACT

If we are to emphasize professionalism within nursing, students need to understand the opportunities, responsibilities, and concerns that are integral to the nursing profession. Sharing ideas related to nursing practice in a specified area with practicing nurses, expert faculty, and a speaker provide students with a sense of excitement about their chosen career. The sponsored seminar series permits undergraduate nursing students to converse with their future colleagues over dinner, develop lasting relationships, and advance their learning in an area of interest.
Botulinum Toxin Chemo-Denervation for Strabismus in Infants and Children
Authors: Magoon Elbert H
Published: April 2021

SUMMARY

Fifteen children and five infants with short follow-up show chemo-denervation with botulinum toxin to be a safe and effective alternative to surgery.
Treatment of Retinoblastoma With Argon Laser Photocoagulation
Authors: Masuyama Yoshimasa , Fukuzaki Masashi , Kodama Yoshihisa , Baba Yukio , Sawada Atsushi
Published: April 2021

SUMMARY

Treatment of retinoblastoma with argon laser photocoagulation in a five-month-old boy is described. His right eye had been enucleated for a large retinoblastoma. A small lesion in the left eye was successfully treated with argon laser. The patient has retained good vision without any complication and there has been no evidence of recurrence for four years.
Horizontal Transposition of the Vertical Rectus Muscles for Treatment of Ocular Torticollis
Authors: von Noorden Gunter K , Jenkins Rachael H , Rosenbaum Arthur L
Published: April 2021

ABSTRACT

In most instances, a head tilt to either shoulder is caused by hypertropia or cyclotropia and responds well to conventional surgical strengthening or weakening operations on the cyclovertical muscles. Occasionally, an ocular head tilt occurs in the absence of cyclovertical strabismus, in association with congenital nystagmus or without an apparent cause. We have successfully treated four of five such patients by surgically rotating the eye(s) around the sagittal axis. This was accomplished by horizontal transposition of the vertical rectus muscles. No complications were encountered. We present this method as a viable alternative to other surgical approaches to rotate the eyes around their sagittal axis.
Results of Cryotherapy at Different Locations for Retinopathy of Prematurity
Authors: Hindle N Warren
Published: April 2021

ABSTRACT

Fifty eyes with stage 3 plus retinopathy of prematurity (ROP) were treated with cryotherapy. The avascular retina (AR) only was treated in 15 eyes with a mean extent of 8.3 hours of stage 3 ROP; the ridge extra reti nal fibrovascular proliferation complex (REFP) was treated in 17 eyes with a mean extent of 7.5 hours; and both locations (BL) were treated in 18 eyes with a mean extent of 7.7 hours. Ninety-three percent to 94% of eyes in each group had less than grade III retrolental fibroplasia (RLF-Reese). However, 87% of the AR treated eyes, 59% of the REFP treated eyes, and 44% of the BL treated eyes had less than grade Il RLF. Whether more than or less than 8 hours of stage 3 ROP was treated, significantly better results occurred in the AR group than the BL group (.02 < P < .05) and a statistical trend suggests that treating the AR is more effective than treating the REFP (.1 < P < .2).
Episodic Exotropia From Lateral Rectus Neuromyotonia-Appearance and Remission After Radiation Therapy for a Thalamic Glioma
Authors: Barroso Luiza , Hoyt William F
Published: April 2021

ABSTRACT

Sixteen months after radiation therapy for a moderately anaplastic astrocytoma of the thalamus, a 7-yearold boy developed spontaneous episodic contractions in his left lateral rectus muscle. During these episodes, lasting 10 to 30 seconds and occurring 20 or more times a day, he had exotropia, limitation of adduction, and retraction of the left globe. This phenomenon peaked in duration and frequency at 14 months and gradually disappeared after 22 months.

As this case confirms, radiation injury to the abducens nerve can cause ocular neuromyotonia, resulting in episodic strabismus. Our case also illustrates that this condition can disappear completely after many months.
Ocular Findings in Premature Infants With Grade IV Intraventricular Hemorrhage
Authors: King Kevin M , Cronin Cathleen M
Published: April 2021

ABSTRACT

Grade IV intraventricular hemorrhage (IVH) is a severe complication of premature birth. We retrospectively performed serial exams on 13 infants with grade IV IVH and compared their ocular findings to 11 infants matched by gestational age and birth weight without an IVH. All children in the study were initially examined in the neonatal unit within 8 weeks after birth. Subsequent periodic eye exams were performed until 3 to 7 years of age.

Of the 13 grade IV IVHs, there was a 92% incidence of ocular abnormalities, compared to a 73% incidence in the premature group without IVH. The children with grade IV hemorrhages had a statistically significant increased incidence of severe eye disease with resultant visual loss (38%) compared to the non-IVH group. Loss of vision was due to optic atrophy and retinopathy of prematurity.

Grade IV IVH children are at high risk for severe eye disease and should have early and frequent ophthalmologic exams.
A Comparison of the Success Rates of Resident and Attending Strabismus Surgery
Authors: Wisnicki H Jay , Repka Michael X , Raab Edward , Hamad Giselle G , Kirsch David , Nath Ajay , Loupe Donna N
Published: April 2021

ABSTRACT

Residency training involves surgery by resident surgeons at various levels of experience and proficiency, supervised by an experienced attending physician. We reviewed the results of strabismus surgery performed at four institutions with two residency training programs. Five hundred twenty-two cases with follow up greater than 6 weeks were evaluated. These cases included 315 attending procedures and 207 resident procedures under direct attending supervision. Success was defined as a strabismic deviation of 8 prism diopters or less. Average postoperative follow-up was 57 weeks and did not differ between groups. There was no statistical difference between the resident success rate of 58% (121/207) and the attending success rate of 69% (217/315) after adjusting for population differences. The average final deviation of the patients postoperatively was 7 Δ for the attending group and 10 Δ for the resident group. Amblyopia was significantly more frequent in the resident cases (P < .001). Adjustable sutures were used significantly more often in attending cases (P < .0001). This study supports the premise that resident strabismus surgery is as successful as attending surgery.
Augmented Surgery for Esotropia Associated With High Hypermetropia
Authors: Wright Kenneth W , Bruce-Lyle Leslie
Published: April 2021

ABSTRACT

Historically, surgical formulas for the management of accommodative esotropia have been based on the residual deviation with full hypermetropic correction. This "standard surgery" has resulted in a high incidence of undercorrection. In response to the large number of undercorrections with standard surgery, the authors have devised a formula for augmenting the amount of rectus recession based on the average of the near deviation with and without correction. In this study, we compare augmented surgery to standard surgery in patients who underwent bilateral medial rectus recessions for residual esotropia after prescribing full hypermetropic spectacle correction. Seventy patients with acquired esotropia after 6 months of age, and hypermetropia of +3.00 or more, were retrospectively studied. Thirty of these patients had undergone standard surgery, while 40 had augmented surgery. The follow up on each group was at least 1 year. Of the 30 patients in the nonaugmented group, 22 (74%) had postoperative deviations of 10 prism diopters or less with 8 (26%) showing a significant undercorrection. Of the 40 patients who received augmented surgery, 35 (88%) had postoperative deviations of 10 δ or less and 5 (12%) were exotropic while wearing full hypermetropic correction. Of the 5 patients with a consecutive exodeviation while wearing full hypermetropic correction, 2 corrected to orthotropia by reducing the spectacle correction by +1.50 diopters and +1.25 D (93% success), 2 were converted to orthotropia by removing +3.00 spectacle correction (97% success), and 1 continued to have an intermittent exodeviation even after removing spectacle correction. This brought the overall success rate for augmented surgery to 98%. Fusion results, as measured by Worth Four Dot (W4D) or Titmus Stereo Acuity, showed 10 of the 30 patients with standard surgery (33%) achieved at least peripheral fusion, whereas 26 of 40 (65%) in the augmented group had postoperative fusion. Our conclusion is that augmented surgery provides better postoperative alignment and fusion than standard surgery. We recommend surgical recessions based on the average of the near deviation with correction and near deviation without correction.
Visual Loss in Infantile Osteopetrosis
Authors: Ainsworth John Ross , Bryce Iain Gardner , Dudgeon John
Published: April 2021

ABSTRACT

Osteopetrosis should be considered in an infant with unexplained visual loss. In particular, the possibility of this diagnosis must be intimated to the radiologist involved in the investigation of the child.
Pediatric Aphakic Contact Lens Wear: Rates of Successful Wear
Authors: Moore Bruce D
Published: April 2021

ABSTRACT

Two hundred thirty-eight consecutive patients with pediatric cataracts were fitted with a variety of aphakic contact lenses after cataract extraction. Thirty-nine patients did not return for follow up. Of the remaining 199 patients, 40 discontinued contact lens wear. None of the 78 patients with unilateral or bilateral acquired cataracts discontinued contact lens wear due to problems wearing their lenses, although nine discontinued contact lens wear due to poor vision or difficulty maintaining amblyopia treatment.

Twenty-two of 84 patients with unilateral congenital cataracts discontinued lens wear, six directly due to difficulties wearing lenses. Sixteen had poor vision in their aphakic eye and an inability to maintain patching for amblyopia. Eight of 37 patients with bilateral congenital cataracts discontinued lens wear because of problems wearing their lenses, and one other discontinued lens wear because of poor vision.

In summary, 26 of 40 patients (out of a total of 199) that discontinued aphakic contact lens wear did so because of poor vision, while only 14 did so because of difficulties wearing the contact lenses. Eleven of these 14 patients were able to wear aphakic spectacles in lieu of contact lenses. This study shows that most pediatric patients with cataracts fail at treatment because of problems related to treatment of amblyopia, and not problems related to the fitting and wearing of contact lenses.
Normal Intraocular Pressure in Children: A Comparative Study of the Perkins Applanation Tonometer and the Pneumatonometer
Authors: Jaafar Mohamad S , Kazi Ghulamqadir A
Published: April 2021

ABSTRACT

We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 5 years of age and 12 normal, volunteer adults with the Perkins hand-held applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). Neither sedation, general anesthesia, nor lid specula were used. We confirmed others' findings that the normal IOP, measured in the supine position with the Perkins, is lower in infants and young children (x = 5.89 mm Hg) than in adults (x = 13.21 mm Hg; P < .0001). On the other hand, with the Pneuma, the supine pediatric IOP (x = 14.76 mm Hg) was not significantly different from the adult sitting IOP (x = 14.42 mm Hg; P = .497). Regression analysis suggests that children and adult Perkins IOP may become equal at around age 12 years.
The Intraoperative Oculocardiac Reflex as a Predictor of Postoperative Vaso-Vagal Responses During Adjustable Suture Surgery
Authors: Hertle Richard W , Granet David B , Zylan Sule
Published: April 2021

ABSTRACT

Adjustable suture surgery has become a popular method of strabismus correction in those cases in which results are less predictable, such as reoperations, thyroid ophthalmopathy, and blind eyes. Complications related to adjustable strabismus surgery are, in general, no different than those related to standard surgical techniques. We noticed a subgroup of patients who experienced significant vaso-vagal responses (V-VR) during postoperative adjustment and sought to discover a method of identifying these patients prior to adjustment.

Sixty patients were studied prospectively from July 1991 to July 1992. All patients had surgery under general anesthesia and were adjusted 24 hours later. A positive oculocardiac reflex (OCR) occurred when a 10% or greater intraoperative change in heart rate was associated with traction on an extraocular muscle. A positive V-VR postoperatively consisted of one or more subjective findings (dizziness, light-headedness, nausea, or body temperature changes), and two or more objective findings (10% or greater change in heart rate, hypotension, pallor, diaphoresis, vomiting, disorientation, or loss of consciousness). Variables studied for predictive value included OCR, age, sex, strabismus type, previous surgery, muscle adjusted, and systemic disease.

Twenty-five patients (41.6%) had a positive V-VR during adjustment. Twenty-seven patients (45%) had a positive OCR. Eighty-five percent of patients with a positive OCR and 9% of patients with a negative OCR had a positive V-VR. Younger patients were also more likely to have a positive V-VR.

A positive intraoperative OCR under general anesthesia during strabismus surgery is highly predictive of a postoperative V-VR during planned adjustment.
Facial Asymmetry in Superior Oblique Muscle Palsy
Authors: Wilson M Edward , Hoxie Judith
Published: April 2021

ABSTRACT

Facial asymmetry is an underrecognized association or sequela of torticollis in congenital or very early onset superior oblique muscle palsy, which when present in an adult, helps to confirm chronicity and prevent unnecessary neurologic evaluation. Nineteen cases of superior oblique muscle palsy were studied prospectively. Of 12 unilateral palsies presenting in adulthood, 9 were considered congenital by history and 7 (77%) of these had facial asymmetry. Large vertical fusional vergence amplitudes and torticollis, on review of childhood photographs, confirmed the early onset of the palsy in each facial asymmetry patient. In addition, two children presenting at age 18 months and 3 years of age with constant head tilting had facial asymmetry. If torticollis is corrected before maturation of the facial structure, resolution of the asymmetry may occur.
Cyclotorsion in Unilateral and Bilateral Superior Oblique Paresis
Authors: Kraft Stephen P , O'Reilly Carole , Quigley Paula L , Allan Karen , Eustis H Sprague
Published: April 2021

ABSTRACT

We studied excyclotorsion prospectively in 12 norv strabismic normal patients, 24 patients with unilateral superior oblique paresis (SOPX and 14 patients with bilateral SOP to determine which test and position, and what amount of torsion best discriminates between bilateral and unilateral SOP For each patient, we measured torsion at near in primary position and in 20° downgaze, using both the double Maddox rod (DMR) and Bagolini lens (BL) tests. We calculated the average of three measurements for each test in each position and the differences in mean excyclotorsion between downgaze and primary position for each patient for each test. Tb discriminate between unilateral SOP and normal, and bilateral and unilateral SOP patients, the best test and position combination was the DMR in downgaze (P = .0001). The probability of a torsion measurement indicating a unilateral SOP rather than a normal value was 95% at 6° of excyclotorsion; of bilateral rather than unilateral SOP, 90% at 20°. The range in the three torsion readings within patients with either DMR or BL in either position varied up to 7°.
Effect of Oral Chloral Hydrate Sedation on the Intraocular Pressure Measurement
Authors: Jaafar Mohamad S , Kazi Ghulamqadir A
Published: April 2021

ABSTRACT

We measured the intraocular pressure (IOP) of 50 normal, cooperative, awake children below 6 years of age and 10 glaucoma patients with the Perkins' handheld applanation tonometer (Perkins) and the Digilab pneumatonographer-tonometer (Pneuma). The measurements were repeated after oral chloral hydrate administration in the dose of 1 00 mg/kg body weight for the first 10 kg plus 50 mg/kg for every additional kg. There were no clinically or statistically significant changes in IOP measured before and after chloral hydrate in the 50 normal children (Pneuma: x" = 14.74 ± 1.27 mm Hg vs 14.74 ± 0.96 mm Hg; P > .05; Perkins: ? = 5.86 ± 1.69 mm Hg vs 5.61 ± 1.50 mm Hg; P > .05) or in the 15 glaucomatous eyes (Pneuma: ? = 28.93 ± 5.26 vs 28.47 ± 4.42 mm Hg; Perkins: ? = 20.27 ± 5.36 vs 19.53 ± 4.49 mm Hg; P > 0.05). Although some children did resist swallowing the bitter-tasting medicine, no significant side effects were encountered. The high-dose oral chloral hydrate protocol resulted in efficient sedation in children below the age of 6 years, without any alteration of the IOP levels in both normal and glaucomatous eyes.
Vernier Acuity in Amblyopic and Nonamblyopic Children
Authors: Cox James F , Suh Steven , Leguire Lawrence E
Published: April 2021

ABSTRACT

We measured vernier acuity in normal and amblyopic children using a procedure that resembles a video game and is suitable for testing most children older than 4 years old. In this procedure, subjects align bars using two keys of a computer keypad. Following binocular practice trials, monocular vernier acuity was measured in 38 control children, 5 to 15 years old, and in 18 children with histories of amblyopia. Vernier acuity was defined as the standard deviation of adjusted position across a block of six trials. Vernier acuity improved as a function of age in the control subjects, indicating developmental improvement. Amblyopic subjects with strabismus (n=5) and with both anisometropia and strabismus (n=8) showed markedly impaired vernier acuity in their amblyopic eyes, with vernier acuity s four to five times larger than those of age-matched controls. However, the amblyopic subjects who were anisometropic (n=5), without any history of strabismus, were not significantly different from control subjects in either eye. Testing with bars and gratings gave similar results. To our knowledge, this is the first study showing that vernier acuity deficits seen in adult amblyopes are also seen in child amblyopes.
The Genetics of Retinoblastoma and Current Diagnostic Testing
Authors: Smith Barbara J , O'Brien Joan M
Published: April 2021

ABSTRACT

We review the genetics of retinoblastoma and the most recent molecular detection methods. Retinoblastoma, the most common intraocular tumor in children, occurs in either a heritable or non-heritable form. The heritable form, which is highly penetrant and predisposes individuals to a considerably greater second tumor risk, can be distinguished most definitively through the use of genetic testing. Genetic testing for individuals and families suspected of carrying the heritable mutations can help ensure that more comprehensive treatment plans and accurate genetic counseling for affected individuals and their families are provided.
Ocular Motility in Parkinson's Disease
Authors: Repka Michael X , Claro Martha C , Loupe Donna N , Reich Stephen G
Published: April 2021

ABSTRACT

Introduction: Parkinson's disease is associated with multiple abnormalities of both the afferent and efferent visual systems. Blepharospasm, paucity of blinking, apraxia of lid opening, visual neglect, reduced vergence, reduced upgaze, and blurred vision are reported findings in these patients. The association of these findings with the disease, and their duration, severity, and treatment have not been systematically investigated.

Patients and Methods: Patients with Parkinson's disease were prospectively examined. An age-matched control group was recruited from accompanying family members and volunteers. Data recorded included presence of visual complaint, the severity of the Parkinson's disease by Hoehn and Yahr Stage (scale=1 to 5), duration of disease, pharmacologic therapy, visual acuity, ocular motility, accommodation, convergence amplitudes, and the near point of convergence.

Results: Thirty-nine patients were entered into each group, each with 21 men and 18 women. The average patient had had the disease for 8.9 years with a severity index of 2.6. Asthenopia, upgaze deficiency, and convergence insufficiency were significantly more common in the patients with Parkinson's disease than in the controls. Mean geometric visual acuity was poorer in the Parkinson's patients (20/39 compared with 20/28; P<.001).

Discussion: Visual complaints were significantly more common in the Parkinson's patients than in the agematched controls. The frequency of ocular abnormalities was not related to the duration of the disease. Increasing severity seemed to be correlated with the presence of convergence insufficiency and a decline in acuity.
Congenital Central Hypoventilation Syndrome: Ocular Findings in 37 Children
Authors: Goldberg David S , Ludwig Irene H
Published: April 2021

ABSTRACT

Background: Congenital central hypoventilation syndrome (CCHS) is a rare cause of central sleep apnea. Although ophthalmic abnormalities have been reported, the ocular findings have not been discussed in detail.

Methods: We examined or obtained the records of 37 children with CCHS.

Results: Twenty-seven patients were found to have abnormal pupils, most of which were miotic and reacted poorly to light. In 18 cases, the anterior surface of the iris was unusually smooth. Ten of the children with abnormal pupils also demonstrated light-near dissociation. Twenty had strabismus of various types, and 18 showed evidence of convergence insufficiency.

Conclusions: The high incidence of strabismus, pupillary abnormalities, and convergence insufficiency may be a result of neurologic defects in the midbrain.
The Influence of Perinatal Infective Factors on Ophthalmia Neonatorum
Authors: Isenberg Sherwin J , Apt Leonard , Wood Mark
Published: April 2021

ABSTRACT

Background: Ophthalmia neonatorum still blinds approximately 10 000 babies annually worldwide. Identification of contributory maternal perinatal factors could possibly predict which babies are at greater risk for this disease.

Methods: In a randomized prospective study of ophthalmia neonatorum in Kenya, we studied the effect of prophylaxis with povidone-iodine, silver nitrate, and erythromycin in 3117 neonates. Four perinatal factors that may promote ophthalmia neonatorum were investigated: maternal vaginitis, birth in a nonsterile environment, presence of meconium at birth, and postnatal development of endometritis.

Results: No significant difference in the general ophthalmia neonatorum rate was found for any of the four factors (P>.~\4 by Fisher exact test). However, with regard to venereal ophthalmia neonatorum, the 26 infants born to mothers with vaginitis had a relative risk 5.1 times that of the rest of the infants P=0.0013).Their relative risk to develop gonococcal ophthalmia neonatorum in particular was 24.9 times the rest of the neonates (P=0.0000031). Prophylaxis was with povidone-iodine in 12 infants, silver nitrate in two, and erythromycin in 12. The frequency of ophthalmia neonatorum was 25%, 100%, and 33%, respectively (differences not significant).

Conclusion: Neonates born to mothers with vaginitis should be carefully observed for the first postnatal month for the development of ophthalmia neonatorum, even though a prophylactic agent has been used.
Unilateral Pseudophakia in Children Under 4 Years
Authors: Awner Steven , Buckley Edward G , DeVaro John M , Seaber Judy H
Published: April 2021

ABSTRACT

Purpose: We examined the efficacy of intraocular lens implantation (IOL) in children younger than 4 years of age for unilateral aphakic visual rehabilitation.

Methods: Twenty-one patients underwent unilateral cataract extraction, IOL placement, posterior capsulotomy, and anterior vitrectomy between 1990 and 1994. Postoperative vision, refractive change, and complications were monitored prospectively. Two cataract subgroups were analyzed: 12 patients with infantile (congenital and developmental) cataracts, and nine patients with posttraumatic cataracts.

Results: Overall age at surgery averaged 26 months (range 9 to 44 months), with follow up of 5 to 55 months. Fifty-two percent achieved 20/40 or better vision: 42% in the infantile group and 67% in the traumatic group. IOL power averaged 22.6 diopters (D). The difference between predicted and actual postoperative refraction was less than 1 D in 70%. After 6 months, the average change in refraction was 0.50 D (21 patients). An increasing myopic shift of 1.10 D at 12 months (14 patients), 1.80 D at 18 months (nine patients), and 2.90 D after 24 months (eight patients) was noted. This trend was greater in the infantile group. Amblyopia treatment was implemented in 18 patients. Half have completed occlusion successfully, one third continue therapy, 17% are treatment failures, and 11% (two patients) were lost to follow up. Six patients required strabismus surgery; five had infantile cataracts. Postoperative complications occurred in four eyes, two infantile and two traumatic; they consisted of posttraumatic temporal IOL dislocation, corectopia, partial pupillary capture of an IOL, and partial pupillary membrane.

Conclusion: Primary IOL implantation is an effective way to rapidly achieve aphakic visual rehabilitation in preschool children. We continue to evaluate the longterm safety and effects of pediatric pseudophakia.
High Resolution, Dynamic, Magnetic Resonance Imaging in Complicated Strabismus
Authors: Shin Grace S , Demer Joseph L , Rosenbaum Arthur L
Published: April 2021

ABSTRACT

Strabismus cases, especially after previous surgery or trauma to extraocular muscles, often present diagnostic challenges. Conventional clinical tests are helpful in some cases but may be inconclusive. High resolution, dynamic, orbital magnetic resonance imaging (MRI) may yield additional critical information about orbital and extraocular muscle anatomy and function. We report four complicated strabismus cases for which dynamic surface coil MRI helped formulate a precise diagnosis and the most appropriate surgical plan.
The Relationship Between Dissociated Vertical Divergence (DVD) and Head Tilts
Authors: Bechtel Robert T , Kushner Burton J , Morton Gail V
Published: April 2021

ABSTRACT

Introduction: Dissociated vertical divergence (DVD) has been associated with manifest head tilts. Also, DVD has been described as demonstrating a characteristic response to forced head tilt by increasing the size of the DVD on contralateral tilt.

Methods: A series of 116 consecutive patients with DVD associated with infantile esotropia were examined according to a predetermined protocol between 1989 and 1994. Each patient was examined for a manifest head tilt. Also, the response of the DVD to forced ipsilateral and contralateral head tilt was analyzed. In addition, 100 consecutive patients with manifest head tilts were examined and the etiology of the tilt determined.

Results: A manifest head tilt was present in 35% (26/74) of patients with an ocular fixation preference and no prior vertical muscle surgery. None of the patients with alternating fixation and a history of no vertical muscle surgery manifested a head tilt. Most patients responded in the classically described manner by increasing the size of the DVD on forced contralateral tilt and decreasing the size of the DVD on ipsilateral tilt. Atypical responses were not related to the presence of oblique overaction. DVD was the etiology in 9 of 100 consecutive patients with a manifest head tilt.

Conclusions: Patients with DVD often manifest a head tilt. Most respond by increasing the size of the DVD on forced contralateral head tilt and decreasing on ipsilateral tilt. Atypical responses did not appear to be influenced by oblique overaction. DVD is a relatively frequent cause of manifest head tilts.
Randomized Comparison of Diode Laser Photocoagulation Versus Cryotherapy for Threshold Retinopathy of Prematurity: 3-year Outcome
Authors: White Janette E , Repka Michael X
Published: April 2021

ABSTRACT

Purpose: To report the structural and functional outcomes at a minimum of 3 years postmenstrual corrected age following laser- or cryoablation of threshold retinopathy of prematurity (ROP).

Methods: Nineteen patients were entered into a prospective, randomized treatment protocol, in which one eye received cryotherapy and the other received diode laser photocoagulation. Asymmetric eyes were randomly assigned. Two patients have died and five were not available for 3-year outcome exams.

Results: Seven males and five females with a mean birthweight of 638 g and a mean gestational age of 24.9 weeks were examined. Two patients had asymmetrical disease and received laser photocoagulation. Two discordant structural outcomes were present among the 10 symmetrical cases. The laser-treated eyes had the favorable outcome; the cryotherapy-treated eyes had the unfavorable outcome. The geometric mean visual acuity after laser photocoagulation was 20/52; after cryotherapy, it was 20/91 (P=O. 046). The mean refractive error was -6.60 diopters (D) after laser photocoagulation and -7.62 D after cryotherapy. Seven patients (58%) have developed strabismus.

Conclusions: Laser photocoagulation appears to have an outcome at least comparable to cryotherapy when the patients are examined 3 years following therapy. These data, Including visual acuity and refractive error, suggest that laser photocoagulation may have a minimal advantage over cryotherapy in the treatment of ROP.
Myopia Predicts Better Outcome in Persistent Hyperplastic Primary Vitreous
Authors: Cheung Jason C , Summers C Gail , Young Terri L
Published: April 2021

ABSTRACT

Purpose: Persistent hyperplastic primary vitreous (PHPV) is a congenital disorder that presents with a spectrum of ocular anomalies, including cataracts, microphthalmia, and hyaloid vessel remnants. Severe visual loss due to secondary glaucoma and retinal detachment is common. This report evaluates the visual outcome of a variant of PHPV with myopia not associated with glaucoma.

Methods:The records of 23 consecutive patients with the diagnosis of PHPV (all unilateral) from October 1992 to August 1995 were reviewed. All but three patients had a cataract extraction procedure and all underwent amblyopia therapy. Eyes with a phakic myopic refractive error (Rx) or aphakic refractive correction ≤8.5 diopters (D) in the immediate postoperative period were designated as myopic.

Results: Six patients were in the myopic group (Group 1) and 17 in were the nonmyopic group (Group 2). The mean age of diagnosis was 21.1 months in Group 1 versus 2.0 months in Group 2, with a comparable follow-up period of 36 months. The mean preoperative Rx of Group 1 was -7.78 D. The mean aphakic Rx of Group 2 was +18.29 D. Average axial length measurement determined by echography was 22.46 mm in Group 1 and 14.03 mm in Group 2. The mean corneal diameter was 11.3 mm in Group 1 vs 8.9 mm in Group 2. In Group 2, seven eyes developed retinal detachment and four developed glaucoma. These complications did not develop in Group 1 during the follow-up period. Overall functional visual acuity was better in Group 1, with a median visual acuity at final follow up of 20/1 60, as compared with light perception for Group 2.

Conclusions: PHPV eyes with myopia were not detected as early as the typical PHPV eyes, primarily because of less media opacification and near-normal corneal diameters. These eyes showed a more favorable visual outcome as they were less likely to develop typical PHPV-related postoperative complications. Myopic PHPV eyes may require a different management approach.
Predictive Value of Regression and Theoretical IOL Formulas in Pediatric Intraocular Lens Implantation
Authors: Andreo Larry K , Wilson M Edward , Saunders Richard A
Published: April 2021

ABSTRACT

Purpose: Intraocular lenses (IOLs) are being implanted in children with greater frequency and in a wider age range. The accuracy of available regression and theoretical formulas in predicting correct IOL power for pediatric eyes, however, has not been reported.

Methods: We reviewed medical records of 47 consecutive pediatric IOL implantations after cataract extraction that met inclusion criteria. Age at surgery ranged from 2 months to 16 years, with measured axial lengths of the eye between 18.6 and 26.7 mm. For the purpose of this study, the 2-month postoperative refraction was considered the post-IOL refractive outcome. Using preoperative globe axial length, corneal curvature, IOL power, and the A constant for the lens provided by the manufacturer, we employed the four common IOL power formulas (one regression formula [SRK-II] and three theoretical formulas [SRK-T, Holladay, and Hoffer Q]) to predict refractive outcome.

Results: The average difference between predicted and actual postoperative refractive error ranged from 1.2 to 1.4 diopters (D) for all formulas. Predicted postoperative refraction was less than the actual in 89 calculations and greater in 99. No significant differences in predictive accuracy were found in any of the axial length groups (group 1 P=0.79, group 2 P=0.42, and group 3 P=O. 86). All formulas were slightly less accurate in group 3 patients (shortest eyes). In this group, the Hoffer Q formula had the lowest error (1.4 D) and the SRK-II had the highest error (1.8 D). The difference was not statistically significant (P=.86).

Conclusions: In our pediatric study eyes, all four IOL power calculation formulas predicted mean refractive outcome within 1.4 D. Theoretical formulas did not outperform the regression formula.
Long-term Outcome of Neonatal Macular Hemorrhage
Authors: Zwaan Johan , Cardenas Rick , O'Connor Patrick S
Published: April 2021

ABSTRACT

Background:We studied long-term visual acuity in children who had macular hemorrhages at birth.

Methods: Of 1 1 involved children, seven had eye examinations at about age 10. Two were contacted by telephone; two were lost to follow up.

Results: Of the seven examined children, six had normal visual acuities. One had reduced vision in the eye with the macular hemorrhage, possibly related to deprivation amblyopia secondary to slow resorption of the hemorrhage. The two patients contacted by telephone reported normal vision.

Conclusion: Although macular hemorrhages generally resolve without any lasting damage, the outcome may be less favorable In some patients.
Deletion 3q in Two Patients With Blepharophimosis-ptosis-epicanthus Inversus Syndrome (BPES)
Authors: Costa Teresa , Pashby Robert , Huggins Marlene , Teshima Ikuko E
Published: April 2021

ABSTRACT

Background: Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is an autosomal dominant condition mapped to chromosome 3q23. There are several reports of chromosomal abnormalities involving this region with a resultant phenotype that includes BPES.

Method: We reassessed two unrelated boys ages 3 and 5 with BPES and associated nonocular abnormalities. Karyotype, which had been previously reported as normal, was repeated using high-resolution banding techniques, to look specifically at 3q23. Clinical findings were tabulated and compared with previously reported cases.

Results: Both patients proved to have interstitial deletions of chromosome 3, the first Involving bands q22.2q25.1 and the second q22.2q24. The first patient exhibited prenatal and postnatal growth retardation, with global developmental delay, while the second patient had normal growth and development except for speech delay. Both had dysmorphic facies with BPES, flat philtrum, a thin upper Hp, and small chin. In addition, the first boy had an inguinal hernia and hypospadius; the second boy had abnormal auricles and metatarsus adductus.The eight cases of interstitial deletions of 3q2 and six rearrangements involving this region have a remarkably similar phenotype.

Conclusions: Deletion of 3q23 is a recognizable contiguous gene syndrome. Microdeletions of 3q23 should be ruled out in any sporadic case of BPES especially if there are associated nonocular abnormalities.
Congenital Cataract Surgery in Children With Cataract as an Isolated Defect and in Children With a Systemic Syndrome: A Comparative Study
Authors: Spierer Abraham , Desatnik Howard , Rosner Mordechai , Blumenthal Michael
Published: April 2021

ABSTRACT

Purpose: To compare visual acuity outcome in two groups of children who underwent congenital cataract surgery. The first group is one in which an isolated cataract occurred; the second group is one in which cataract occurred in conjunction with a systemic disease.

Methods: A review of 46 charts: 36 children (50 eyes) with congenital cataract as an isolated defect, and 10 children (16 eyes) with cataract as part of a systemic disease.

Results: One third of the eyes with isolated cataract had postoperative visual acuity better than 6/12, although none of the patients in the syndrome group had visual acuity better than 6/12. This difference was statistically significant (p=0.01). Of the various ocular pathologies associated with congenital cataract, only nystagmus was found to be more prevalent in the syndrome group (40%) as compared with the isolated cataract group (11%) (p=0.05). Surgery was performed during the first 2 years of life in 54% of the eyes in the isolated cataract group, and in 87% of the eyes in the syndrome group (p=0.01). There was no difference in the prevalence of the postoperative complications between the two groups.

Conclusion: Children who underwent congenital cataract surgery developed poorer visual acuity if the cataract was a part of a systemic disease as compared with children without a systemic syndrome.
Möbius' Syndrome: Features and Etiology
Authors: Ghabrial Rafat , Versace Patrick , Kourt Georgina , Lipson Anthony , Martin Frank
Published: April 2021

ABSTRACT

Purpose: To review the clinical features and possible aetiology of all cases of Möbius' syndrome presented at the Royal Alexandra Hospital for Children in Sydney, Australia, from 1963 through 1995.

Methods: All charts of patients suffering from Möbius' syndrome were reviewed, and each patient was thoroughly assessed by a geneticist and a pediatrie ophthalmologist.

Results: Patterns of systemic and ocular clinical features became evident. Of 23 patients in the series, 10 (43%) had a history significant events in utero.

Conclusions: All patients suffering from Möbius' syndrome require thorough assessment by a multidisciplinary team including a geneticist or pediatrician and a pediatrie ophthalmologist. Significant vascular events of pregnancy may explain some cases of fetal vascular disruption to the brainstem.