bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning Styles of Students and Faculty in Selected Health Care Professions
Authors: Linares Aletta Z
Published: April 2021

ABSTRACT

The purposes of this study were to determine if students and faculty in nursing and allied health demonstrate a predominant learning style, if there is an association between a specific learning style (converger, diverger, accommodator, or assimilator) and self-directed learning readiness for these groups, if these learning characteristics can predict academic success, and if a discipline-specific learning style can be identified. Marshall and Merritt's (1986) Learning Style Questionnaire and Gughelmino's (1978) Self-Directed Learning Readiness Scale (SDLRS) were administered to 301 generic BSN students, 188 RN-BSN students, 110 allied health students, and 30 nursing faculty from one southwestern university. There were no significant differences in learning style between students and faculty; the converger style was the predominant learning style for all subjects. Faculty were more self-directed than students; although, overall, students scored high on the SDLRS. Selfdirected learning readiness appears to affect learning style. Convergers were significantly more self-directed than either the accommodators, assimilators, or divergere. Academic success, as determined by program completion, could not be predicted on the basis of learning style or selfdirection.
Scholarship Revisited: A Collaborative Nursing Education Program's Journey
Authors: Storch Janet , Gamroth Lucia
Published: April 2021

ABSTRACT

The Collaborative Nursing Program in British Columbia is a nursing education program composed of 10 partners, including five community colleges, four university colleges, and one university. The Board of Accréditation of the Canadian Association of University Schools of Nursing granted a 7 -year accreditation to the Collaborative Nursing Program partners in November 2000. During the past several years, the partners have begun to view their collaborative curriculum development, implementation, and evaluation through the lens of scholarship. Using Boyer's model of scholarship, they have begun to evaluate their work of discovery, integration, application, and teaching against criteria in Scholarship Assessed: Evaluation of the Professorate. This article describes the journey the collaborative partners undertook in exploring the meaning of scholarship across the partnership and within each nursing school.
Grade Disputes: Considerations for Nursing Faculty
Authors: Boley Paula , Whitney Karen
Published: April 2021

ABSTRACT

Nursing faculty take grading of assignments seriously. Faculty realize students are sensitive about their grade point averages and that students must maintain certain grades for progression and the retention of scholarships. Faculty further recognize that the grading of clinical performance is complex and subjective by nature. Some faculty are reluctant to assign a failing grade for poor clinical performance for fear of litigation. In this article, the authors discuss several landmark cases that have come before the courts, which have set precedence for grade disputes. The courts overwhelmingly have supported faculty decisions regarding grade assignment, as long as the grades were not arbitrary or capricious. Nursing instructors should not be fearful of failing a student solely on the basis of poor clinical performance. However, faculty must be prepared to explain how grades are assessed related to the program and course objectives.
Using a Linked Learning Activity to Foster Nursing Students' Professional Growth
Authors: Smith Dawn , Garteig Laureen
Published: April 2021

ABSTRACT

Linked learning assignments employ a learner-centered approach that views differences among students as educationally enriching, rather than problematic. This article describee a linked learning activity that systematically incorporated differences between first-year and fourth-year nursing students to enrich learning outcomes related to professional growth and the image of nursing. The process of developing, implementing, and evaluating this professional growth-United learning activity is described. Thematic analysis of students' and faculty's reflective writing about their experience of the learning activity generated three themes - experiencing collegiality, sharing insider perspectives, and re-envisioning nursing. Suggestions for using linked learning activities to actively engage the diversity present in nursing undergraduate programs are offered. The value of facilitating and providing supportive environments for dialogue among students at various stages of development to promote positive socialization in nursing is discussed.
"Razoo Health": A Community-Based Nursing Education Initiative
Authors: Kraus Marjorie B , Morgan Connie M , Matteson Peggy S
Published: April 2021

ABSTRACT

When statistics depicted a health crisis for people of all ages living in Louisiana, and New Orleans in particular, school of nursing faculty designed and instituted a neighborhood-based initiative to "Razoo Health." This initiative facilitated a paradigm shift from exclusively illness management to include health promotion and disease prevention. "Razoo," a local colloquialism used to claim an opponent's marble during game play, means to snatch or claim. Appropriately, Razoo Health refers to the intent of Louisiana citizens to reclaim and take back the health of the people in the cities' neighborhoods.

Working with four inner-city parochial schools and churches as hubs, nursing faculty and students mobilize neighborhood assets, talents, and capacities to form partnerships for healthy change. The Centers for Disease Control and Prevention Coordinated School Health Model is employed within each neighborhood school to provide health care access, decrease absenteeism, raise test scores, and deliver worksite health programming to faculty and staff and to neighbors and parishioners. Nursing students work with citizens and students of other health care professions to learn community assessment skills and deliver primary, secondary, and tertiary services to individuals, families, and the community. Citizens wear crowns of empowered sovereignty as they take back, or razoo, what is rightfully theirs - health.
Undergraduate Community Health in the First Semester: Opportunities and Challenges
Authors: Speck Barbara J
Published: April 2021

ABSTRACT

In the current health care environment, there is a trend for care to move from acute hospital settings to community settings. The Pew Health Professions Commission and the American Association of Colleges of Nursing identified a need to modify health care professional education to meet the needs of the changing health care system and diverse demographics in the United States. In traditional baccalaureate nursing programs, the community health nursing course typically is taken in the last year, after students have completed medical-surgical nursing courses. This article describes a curriculum that begins with the community health nursing course. Many opportunities and challenges related to this placement are described.
Solutions to Finding Graduate Clinical Sites for Advanced Health Assessment
Authors: Kessler Theresa A
Published: April 2021

ABSTRACT

Finding pediatrie clinical sites for students in advanced health assessment courses can be challenging. By using creative planning, new methods of acquiring additional clinical sites can be developed. Three specific ideas for new site acquisition, as well as potential limitations, are suggested.
Bilateral Ocular Dermoids, Preauricular Appendages, and Canthal Malocclusion Associated with Facial Asymmetry
Authors: Van Riet Lieven J , Stewart Dudley M
Published: April 2021

Report of A Case
Bilateral Acquired Inflammatory Brown's Syndrome
Authors: Moore A T , Morin J D
Published: April 2021

ABSTRACT

An 11-year-old boy presented with fever, skin rash, joint pains and vertical diplopia, and was found to have a right Brown's syndrome and systemic onset Juvenile Rheumatoid Arthritis ( JRA). Later in the course of his illness, he developed a left Brown's syndrome. Acquired Brown's syndrome may occur as a complication of JRA during exacerbations of the systemic inflammatory disease.
Outcome of Treatment of Marked Ametropia Without Strabismus Following Screening and Diagnosis Before the Age of Three
Authors: Friedman Z , Neumann E , Abel-Peleg B
Published: April 2021

ABSTRACT

Following early treatment of 39 consecutive cases with marked ametropia without strabismus, diagnosed by screening at the age of one to two and a half years, residual amblyopia was found in 20 (51%), including six (15%) with bilateral amblyopia, but with relatively good visual acuity in at least one eye. Anisometropia showed the highest rate of residual amblyopia.

The main changes in refraction that occurred from the age of screening to the age of seven years was myopisation, especially in hypermetropic eyes without amblyopia.

Heterotropia, always intermittent, developed in six of the 39 cases. Pull stereopsis could be found in eight cases only, all without amblyopia. The majority, whether amblyopic or not, had partial binocular functions but four cases, all amblyopic, had none.
Treatment of Persistent Hyperplastic Primary Vitreous
Authors: Pollard Zane F
Published: April 2021

ABSTRACT

Thirty-two patients with persistent hyperplastic primary vitreous were examined by the author over a 10-year period. Two patients have been followed with conservative management. Thirty patients were treated with surgery involving lensectomy with anterior vitrectomy being performed as the minimal treatment, with a few patients being treated with a full vitrectomy and dissection of the PHPV stalk from the posterior lens surface to the retina. The only eyes which obtained a good visual result were those eyes which contained only the anterior PHPV without the posterior segment being involved. While surgery on the posterior segment was anatomically successful, poor visual results were obtained due to retinal abnormalities. No eye has been removed. Five eyes have useful vision. Early treatment is advised in order to prevent underdevelopment of the orbit secondary to early enucleation as well as to treat amblyopia in those visually salvageable eyes.
Hyaloid Vascular Pattern in the Human Fetus
Authors: Ko Myung-Kyoo , Chi Je G , Chang Bong-Lean
Published: April 2021

ABSTRACT

The hyaloid vascular system of developing human eyeballs is studied to elucidate the relationship to the retinal vascular patterns. The process of the regression of the hyaloid vascular system in fetuses consisted of gradual shrinkage of the wall of the vessels with lessening of the lumen and eventually, thread-like acellular strands that remained as a consequence. The intercapillary bridge in the retinal vessel appeared to be a remnant of the degenerated vessel as in the hyaloid vascular system.

At the ninth month of intra-uterine life, the regression of the hyaloid vascular system was almost complete.
Ocular Deficiencies in Deaf Children
Authors: Regenbogen Lucian , Godel Victor
Published: April 2021

ABSTRACT

In a sample of 150 deaf children, 45.3% were found to present ocular anomalies interfering with good vision. This high frequency of visual impairment contributes to the low-level functioning and lack of normal developmental drives characteristic of deaf children. Early identification, competent diagnosis and appropriate intervention by a team of specialists are required in the treatment of such cases.
Electroretinography: Application to Clinical Studies of Infants
Authors: Fulton Anne B , Hansen Ronald M
Published: April 2021

ABSTRACT

The electroretinographic (ERG) responses of normal human infants have been studied in scotopic conditions. The relation of stimulus intensity to the amplitude of the b-wave of the ERG undergoes developmental changes during infancy. The maximum amplitude that can be obtained gradually increases to approach adult values by age 12 months. Sensitivity, however, is equivalent to that of adults at age five to six months. Latencies reach adult values at the end of the first year.

Some results of ERG testing of infant patients with retinal disorders are compared to the normal results. As previously reported for animals and human adults with retinal disorders, amplitude, sensitivity and latency are not always equally compromised by the retinal diseases of infants.
Masked Blepharoptosis
Authors: Lockhart Lonn Bradley , Biglan Albert W
Published: April 2021

ABSTRACT

The eyelid of a patient with apparent unilateral blepharoptosis and a preference for fixation with the contralateral eye, was corrected surgically. However, postoperatively when the preferred (unoperated) eye was used for fixation, the ptosis appeared to have been overcorrected. When the non-preferred (operated) eye was forced to take up fixation, the overcorrected lid position resolved, but ptosis of the unoperated eyelid was unmasked. Surgical correction of this previously masked ptosis ultimately produced a satisfactory result. Our experience emphasizes the importance of ocular fixation preference when evaluating patients with blepharoptosis.
A Comparison of the Succinylcholine Induced Ocular Position and the Postoperative Alignment in Strabismus
Authors: Lingua Robert W , Azen Stanley P , Walonker Frances , Levin Lori , Baker Sherryl
Published: April 2021

ABSTRACT

Succinylcholine was injected intraoperatively in 41 strabismus patients with congenital esotropia or intermittent or constant exotropia. Regression analyses were performed to investigate the predictive relationships between the one-, six-, and 26-week postoperative alignment and the intraoperative, succinylcholine-induced ocular position. Ocular position, determined by the interlimbal distance in millimeters, was calculated using a semi-automated, video replay analysis system. Large, statistically significant correlation coefficients were obtained for patients undergoing bimedial recessions of 4.0 to 5.5 mm and bilateral lateral rectus recessions of 5.0 to 7.0 mm. Small correlations were obtained for esotropes undergoing the recession/ resection procedure and those with bimedial recessions of 6.0 mm or greater. These data support the theory that the succinylcholine-sensitive subgroup of the extraocular muscle fibers are those whose tonic contracture provide the motor component to ocular alignment. Sample sizes at present are insufficient to suggest clinical use of these data. In future research, these relationships will be tested for their ability to predict postoperative alignment and thereby, improve success rates in strabismus surgery.
Extraocular Muscle Aplasia in Moebius Syndrome
Authors: Traboulsi Elias I , Maumenee Irene H
Published: April 2021

ABSTRACT

A case of Moebius syndrome with bilateral aplasia of the medial and lateral recti is reported. The fibrous bands that replaced the medial recti were inserted posteriorly on the globe resulting in a restrictive large angle esotropia. Surgical intervention resulted in alignment in the primary position. The present case favors a primary mesodermal dysplasia of the extraocular musculature in Moebius syndrome.
Ocular Manifestations of Tubercular Meningitis: A Clinico-Biochemical Study
Authors: Lamba P A , Bhalla J S , Mullick D N
Published: April 2021

ABSTRACT

Forty-eight children with tubercular meningitis were observed and followed up for development of ocular sequelae over a period of four months. Commonest ocular abnormality encountered in this condition was optic disc change (62%) of which papillitis was the most frequent. The incidence of pupillary change and cranial nerve paralysis was seen to be 48% and 28% respectively. Anisocoria and mydriasis were commonly observed pupillary changes. The third cranial nerve was the most frequent nerve involved in this condition. It was observed that patients who had high CSF protein content (>75 mg%) showed more chances of development of primary optic atrophy (P value 0.001). Choroidal tubercle and papilledema were found to be signs of grave prognostic significance.
Congenital Ocular Fibrosis Syndrome Associated With the Prader-Willi Syndrome
Authors: Kalpakian Basilio , Bateman J Bronwyn , Sparkes Robert S , Wood G Kenneth
Published: April 2021

ABSTRACT

We report an 11-year-old boy with both the congenital ocular fibrosis and the Prader-Willi syndromes. Since birth he has had bilateral blepharoptosis and fixed ocular misalignment in downward gaze. Pathological examination of the extraocular muscles showed replacement by fibrous tissue. Additionally, the child had the typical clinical features of the Prader-Willi syndrome including mental retardation, hypotonia, short stature, hypogonadism, and obesity. The Prader-Willi syndrome has been consistently associated with interstitial deletions of the long arm of chromosome 15. Although our patient appeared to have normal chromosomes, he may indeed have an undetectable deletion which may be responsible for both syndromes. We believe that the gene(s) for the congenital ocular fibrosis syndrome may be located near the gene(s) for the PraderWilli syndrome on the long arm of chromosome 15.
Unilateral Blepharoptosis With Synkinetic Movements of the Eyelids on Horizontal Gaze
Authors: Rice Charles D , Weaver R Grey , Benjamin Eugene , Troost B Todd
Published: April 2021

ABSTRACT

A 17-year-old woman with a left congenital ptosis and an alternating esotropia is presented. During horizontal gaze to the right and left, the eyelid of the abducting eye elevated and the eyelid of the adducting eye lowered. There were no synkinetic eyelid movements with contraction of the pterygoid, sternocleidomastoid, or facial muscles. Synkinetic eyelid movements due to aberrant regeneration were unlikely due to absence of previous third nerve palsy. A supranuclear innervational abnormality is proposed to explain the clinical findings.
Rod ERGs in Children With Hereditary Retinal Degeneration
Authors: Birch David G , Fish Gary E
Published: April 2021

ABSTRACT

Rod ERGs were obtained over a broad range of stimulus intensities from young patients with retinitis pigmentosa and progressive cone-rod degeneration. Intensity-response functions suggest that children with retinitis pigmentosa have reductions in the number of functioning rods and that surviving rods generating the ERG have reduced sensitivity. Children with cone-rod degeneration also have reduced numbers of rods, but the remaining rods have normal sensitivity. These findings suggest that the underlying mechanisms of rod degeneration differ in these two forms of disease and demonstrate that insights into the pathogenesis of hereditary retinal degeneration can be obtained by testing children. The ability to distinguish between retinitis pigmentosa and cone-rod degeneration in children is also important because of differences in the rates of progression between the two classes of progressive retinal degeneration.
Nasal-Oropharyngoscopy: A Simple Test to Evaluate Lacrimal Duct Function in Children
Authors: Gammon J Allen , Wilmeth J Philip , Guo Su Qin , Gemmill Mary
Published: April 2021

ABSTRACT

Obstruction of the lacrimal drainage system is a common problem in pediatric ophthalmology. We describe a simple office test which allows the patency of the lacrimal drainage system to be visualized.
Superior Oblique Tenotomy in the Treatment of Isolated Inferior Oblique Paresis
Authors: Reese Paul D , Scott William E
Published: April 2021

ABSTRACT

Both tenotomy and tenectomy of the homolateral superior oblique muscle have been advocated as surgical treatment for isolated paresis of the inferior oblique muscle. An iatrogenic superior oblique palsy has been reported to be a frequent complication of superior oblique tenectomy. This complication appears to be less frequent following superior oblique tenotomy. Of 16 consecutive patients with isolated inferior oblique paresis treated by homolateral superior oblique tenotomy and followed an average of 5.0 years (range six months to 11.6 years), only two patients demonstrated a superior oblique palsy postoperatively. Large vertical deviations with spread of comitance, however, required a superior rectus recession of the fellow eye in addition to superior oblique tenotomy.
Secondary Cataracts in Infants After Lensectomies
Authors: Morgan Keith S , Karcioglu Zeynel A
Published: April 2021

ABSTRACT

Three infants, one who was two weeks old, and two who were two months old, underwent lensectomy and vitrectomy in a total of four eyes for congenital cataracts by means of an automated suction cutter. Two patients with unilateral opacities underwent combined cataract extraction and epikeratophakia, and one with bilateral congenital cataracts underwent cataract extractions and was fit with extended wear contact lenses. In all cases, the surgery involved at least a 5-mm posterior capsulotomy with a shallow anterior vitrectomy, and was uneventful. Three of the four eyes developed new opacities that required surgical removal three to five months after the original surgery. Cytological evaluation of the specimen obtained from one patient showed this material to be lens epithelium. In all three cases, the material grew without the support of the posterior capsule; in one patient the material appeared to have seeded onto the iris. This previously unreported complication in infants with congenital cataracts who have undergone posterior capsulotomy and anterior vitrectomy emphasizes the need for frequent retinoscopies on such patients. The absence of the posterior capsule does not guarantee that these children will not develop secondary growth of lens epithelium which may obstruct the visual axis.
Herpes Simplex Keratitis and Amblyopia
Authors: Beneish Raquel G , Williams Frances R , Polomeno Robert C , Flanders Michael E
Published: April 2021

ABSTRACT

Herpes simplex keratitis can cause severe loss of vision in children. The findings in five children show that amblyopia is caused by stimulus deprivation and/or anisometropia. Early medical treatment, occlusion therapy, and frequent refractions are crucial for a good visual prognosis.
Congenital Orbital Vascular Malformation Complicated by Massive Retrobulbar Hemorrhage
Authors: Kremer Israel , Nissenkorn Ilana , Feuerman Peter , Ben-Sira Isaac
Published: April 2021

ABSTRACT

A 2-year-old female infant with a presumed diagnosis of infantile hemangioma of the left eyebrow developed acute proptosis of the left eye several days after a mild orbital trauma. Computerized axial tomography (CAT) and carotid angiography confirmed the presence of a vascularized mass in the retrobulbar space, spreading anteriorly to the orbital rim and the frontal area. Due to progression of the proptosis and the development of exposure keratitis, surgical intervention was necessary. A large vascular tumor and a massive hemorrhage occupying the orbit were removed. The pathological examination confirmed the diagnosis of a vascular malformation of the orbit, most probably orbital varices. A relatively good visual acuity was achieved after surgery by occlusion therapy.
The Polarized Three-Dot Test
Authors: Arthur Brian W , Keech Ronald V
Published: April 2021

ABSTRACT

A new binocular sensory test was designed using polarizing filters. The polarized three-dot test (P3D) subtends the same visual angle as the Worth four-dot test (W4D). Sensory testing was performed at distance and near in 100 patients using the W4D and P3D tests. Every patient reliably completing the W4D test also completed the P3D test. Twelve patients failed to complete both tests. Fifteen patients could not reliably complete the W4D test but were able to perform the P3D, thus increasing the interpretable response rate from 73% for the W4D test to 88% for the P3D (chi square, p < .0001).

In every case but one, fusion by W4D testing was also found by the P3D test. In addition, the P3D identified 19 cases of fusion not found by W4D testing. The results suggest that the P3D test is superior to the W4D test in the clinical assessment of central and peripheral fusion.
Contrast Sensitivity Letter Charts as a Test of Visual Function in Amblyopia
Authors: Loeffler Michael , Wise Jack S , Gans Mark
Published: April 2021

ABSTRACT

Anisometropie and strabismic amblyopes were studied using the Regan Contrast Sensitivity Charts. At all levels of contrast, the amblyopic eyes of both the strabismic and anisometropic patients scored significantly lower than did their fellow normal eyes, which were used as controls. In comparing the differences between the normal and amblyopic eyes of both groups, we noted a normalization of the visual function of strabismic amblyopes at low contrast. This feature was not observed in the anisometropic amblyopes who consistently scored poorly when viewing either the high or low contrast chart.
Amblyopia: The Normal Eye is Not Normal
Authors: Leguire Lawrence E , Rogers Gary L , Bremer Don L
Published: April 2021

ABSTRACT

When acuity was used to evaluate amblyopia in children, the amblyopic eye had decreased acuity and the nonamblyopic eye had normal acuity. However when Contrast Sensitivity Functions (CSFs) were used to evaluate amblyopia, losses in the CSF were discovered in both the amblyopic and the nonamblyopic eyes. During the course of occlusion therapy, the amblyopic eye improved in acuity and CSF and the nonamblyopic eye improved in CSF. The results suggest that the nonamblyopic eye is not normal and that the CSF provides additional information to acuity about amblyopia in children.
Ophthalmologic Findings in the Cornelia de Lange Syndrome
Authors: Levin Alex V , Seidman David J , Nelson Leonard B , Jackson Laird G
Published: April 2021

ABSTRACT

Cornelia de Lange Syndrome (CDLS) is characterized by mental retardation, growth retardation, skeletal anomalies, and a characteristic facies. We examined 22 children with CDLS to ascertain the relative frequencies of oculofacial and ophthalmologic abnormalities. We confirm prior reports of the frequent findings of brow hypertrichosis, synophrys, and long arcuate eyelashes. In addition we documented the association with ptosis, nystagmus, and high myopia. Contrary to previous reports, we did not find blue sclera or corneal, pupillary, or retinal disorders to be part of this syndrome. Hypertelorism and telecanthus were found, but they were dependent on the method of calculation. Two children had optic nerve pallor. We also report the new findings of poor macular reflex, chin lifts induced by ptosis, hypertropia, and nasolacrimal duct fistula.
Congenital Corneal Anesthesia: Problems in Diagnosis
Authors: Shorey Pavan , Lobo Grace
Published: April 2021

ABSTRACT

Congenital corneal anesthesia (CCA) is a rare clinical entity that presents a whole gamut of problems before lending itself to a diagnosis by the clinician. Not recognizing the history of self-inflicted corneal injuries, not evaluating the corneal sensations in a child with recurrent corneal ulceration, misdiagnosis of such cases as viral keratitis, and not ruling out all the secondary causes of corneal anesthesia, as well as the other causes of self-inflicted injuries, are some of the pitfalls in the diagnosis of congenital corneal anesthesia.

Four cases representative of different aspects of CCA are presented. The problems in the diagnosis of these cases are discussed. A clinical classification of congenital corneal anesthesia is suggested and the systemic anomalies associated with this disorder are enumerated.
The Acuity Card Procedure: Longitudinal Assessments
Authors: Hartmann E Eugenie , Ellis George S , Morgan Keith S , Love Angela , May James G
Published: April 2021

ABSTRACT

Traditional methods of visual assessment in preverbal pediatric patients rely on refined but subjective measurement techniques. A standard ophthalmologic examination includes evaluation of a child's fixation patterns, with performance ranked on the basis of ability to fix and follow an object (F & F) or maintain central, steady fixation (CSM). In the hands of a skilled clinician, these evaluations are important for diagnosis and treatment. Documentation of quantitative changes in visual abilities of preverbal patients, however, has only recently become feasible.

We began using the acuity card procedure in our pediatric clinical practice more than 3 years ago. This assessment, a modified version of the standard Forced-Choice Preferential Looking paradigm (FPL), provides quantitative evaluation of visual functioning in preverbal patients. The total number of patients assessed on one or more occasions exceeds 900. Of this group, we followed 83 patients with at least four acuity card evaluations on separate visits. Thirty of these patients, all with different diseases, have been evaluated with acuity cards on six or more visits.

We found the information provided by the acuity card assessments extremely helpful in quantifying the developmental and therapeutic changes in vision, previously monitored only qualitatively.
Head Nodding Associated With Intermittent Esotropia
Authors: Rubin Steven E , Slavin Michael L
Published: April 2021

ABSTRACT

Head nodding (to-and-fro turning about the vertical cervical axis) associated with abnormal eye movements may be seen in spasmus nutans and congenital nystagmus. In the absence of abnormal eye movements, it may be indicative of neurological disease (eg, cerebellar disease, basal ganglia dysfunction). We report a neurologically normal infant without nystagmus but with intermittent head nodding and intermittent esotropia, whose head movements manifested only when his eyes were straight. The head movements ceased with the occlusion of either eye or spontaneous onset of esotropia. When his head was forcibly stabilized, he immediately developed esotropia. The head movement presumably facilitated fusion, although the mechanism of action is unknown.
Stickler's Syndrome in the Cleft Palate Clinic
Authors: Kronwith Stephen D , Quinn Graham , McDonald Donna M , Cardonick Elyce , Onyx Pam , LaRossa Donato , Borns Patricia , Stambolian Dwight E , Zackai Elaine H
Published: April 2021

ABSTRACT

Stickler's syndrome is a much underdiagnosed entity in the ophthalmic population. It is a dominantly inherited disease of connective tissue whose ocular findings include moderate to severe myopia, vitreoretinal degeneration, retinal detachments, cataracts, and glaucoma. Non-ophthalmologic findings include cleft palate, midfacial hypoplasia (Figs 1-2), radiographic changes of spondyloepiphyseal dysplasia, narrow pelvis, and broad femoral neck.

Twenty percent of patients with Stickler's syndrome will have a cleft palate. We undertook a study to determine the incidence of Stickler's syndrome in patients with an isolated cleft palate, and to see if this screening process would be useful in making an early diagnosis of the syndrome and in genetic counseling.

It is important to distinguish this syndrome from that of isolated cleft palate in order to: 1) insure early detection of myopia and monitor for signs of retinal detachment, cataract, and glaucoma; and 2) provide definitive recurrence counseling for families (50% vs 2.3%).
The Ocular Pathology of Trisomy 22: Report of Two Cases and Review
Authors: Antle C Mark , Pantzar J Tapio , White Valerie A
Published: April 2021

ABSTRACT

Two cases of full trisomy 22 with the associated gross and microscopic pathology are reported. These cases demonstrate the typical craniofacial and organ system anomalies previously reported in trisomy 22 but also exhibit uveal colobomas that, within the spectrum of chromosome 22 anomalies, are usually restricted to the so-called "cat eye" syndrome. The attendant microscopic ocular findings represent, to the best of our knowledge, the first such report in the literature.
Mesectodermal Leiomyoma of the Ciliary Body: New Evidence for Neural Crest Origin
Authors: Yu Dao-Yi , Cohen S B , Peyman G , Tso M O M
Published: April 2021

ABSTRACT

An 8-year-old white boy had a mass of the ciliary body in his left eye. Both the translucent characteristics and the magnetic resonance imaging findings suggested that this lesion was cystic. Fluid aspiration biopsy and iridocyclectomy were performed. By light microscopy the neoplasm showed the characteristic appearance of a neuroid tumor; however, on electron microscopic examination, the tumor exhibited characteristic features of a smooth muscle neoplasm and was diagnosed as a mesectodermal leiomyoma. Observation of melanin granules in scattered tumor cells further confirmed that the tumor had the same origin as uveal melanocytes, which also derive from the neural crest.
Recovery of Phorias Following Monocular Occlusion
Authors: Holmes Jonathan M , Kaz Kian M
Published: April 2021

ABSTRACT

Fourteen nonstrabismic volunteers were monocularly patched for 2 and 24 hours in separate experiments. Horizontal and vertical phorias were measured at 6 m and 30 cm, at 30-second intervals, for at least 30 minutes, following removal of the patch. After 24 hours of monocular occlusion, the initial change from baseline at 6 m ranged from 9.5 prism diopters exo to 7 δ eso and 6.5 δ hyper to 3 δ hypo. At 30 cm, the initial change ranged from 7.5 δ exo to 4 δ eso and 1 δ hyper to 1 δ hypo. In all but three subjects, phorias returned to within 2 δ of baseline by 3 minutes, and in all subjects by 25 minutes. After 2 hours of monocular occlusion, the range of initial change from baseline was similar to 24 hours of occlusion, but all phorias returned to within 2 δ of baseline by 2.5 minutes.

Therefore, we suggest that ocular alignment should not be routinely measured within 3 minutes of removing a patch. If patched for 24 hours, a few individuals will require up to 25 minutes for stabilization of their deviation. Further studies might address these effects in patients with subnormal fusion and stereopsis.
Regression Pattern in Retinopathy of Prematurity
Authors: Preslan Mark W , Butler John
Published: April 2021

ABSTRACT

We characterized the regression pattern of retinopathy of prematurity (ROP) for 266 infants examined over a 22-month period. Infants were included in the evaluation with a birth weight of less than or equal to 1500 g. Regression of retinopathy was observed in all but 11 infants, who were treated for threshold ROP. ROP limited to the peripheral retina resolved around term (40 weeks postconceptional age). Posterior ROP and/or stage 3 ROP underwent a protracted course of resolution, often not reaching zone 3 until 42 to 45 weeks after conception. Permanent retinal/vascular sequelae of ROP were observed in 10% of infants with ROP. The most common abnormality was failure to completely vascularize the temporal retinal periphery. Overall, retinal morbidity from ROP was an infrequent occurrence (18 of 266 premature infants - 6.8%).
Randomized Clinical Trial of Surfactant Prophylaxis in Retinopathy of Prematurity
Authors: Holmes Jonathan M , Cronin Cathleen M , Squires Peggy , Myers Thomas F
Published: April 2021

ABSTRACT

Prophylactic lung surfactant Is commonly used to reduce the severity of neonatal respiratory distress syndrome in premature infants. There is disagreement in the literature regarding the effect of prophylactic lung surfactant on the incidence of retinopathy of prematurity (ROP). Sixty-four Infants, gestatlonal age 23 to 32 weeks, birth weight 610 to 1250 g, were randomized to receive either intratracheal bovine surfactant prophylaxis or air control, at our institution, as part of a national doublemasked multicenter trial. Forty-eight of these infants survived and underwent complete ophthalmologic examinations by a single masked examiner. ROP data were gathered retrospectively. ROP developed in 1 9 of the 23 (83%) who received surfactant and 15 of the 25 (60%) controls (P = .1). Analysis of the worst stage of ROP for each infant also revealed no difference between the surfactant and control groups (P = .4). Our retrospective analysis of ROP data in a prospective double-masked randomized study revealed no significant effect of surfactant on the incidence or severity of ROP.
Susceptibility to Retinopathy of Prematurity in Alaskan Natives
Authors: Arnold Robert W , Kesler Kenneth , Avila Emilio
Published: April 2021

ABSTRACT

Threshold retinopathy of prematurity occurred in 11 of 34 Alaskan natives compared with 10 of 93 non-natives. Natives constitute 16% of the state population. This significant Alaskan native preponderance was not explained by differences in prenatal or intensive care unit morbidity except that the intervals from birth to extubation and birth to cryotherapy were shorter for natives.
A Gyroscope Deviometer for Measurement of Strabismus
Authors: Miller Kevin M , Cooper Kim L , Guyton David L
Published: April 2021

ABSTRACT

We describe a hand-held gyroscope deviometer that an examiner can use to measure strabismic deviations without prisms. The deviometer is ideally suited for use with small children who will not allow prisms to be held near their eyes, and adults with poor fixation in one eye. The device consists of a fixation light attached to a gimbal-mounted single-axis gyroscope. The gyroscope provides the necessary reference for horizontal deviations. Gravity provides the reference for vertical deviations. As the patient observes his or her reflection with the fixing eye in a plane mirror at the end of the room, the examiner positions the corneal light reflex in the pupil of the deviating eye and presses a rocker switch to the "reset" position, zeroing the deviometer. The examiner then aims the deviometer fixation light at a reflection of itself in a plane mirror located on the wall behind the subject and presses the rocker switch to the "read" position. Horizontal and vertical deviations are displayed to the nearest degree. The accuracy of the device is dependent upon the examiner's ability to position the corneal light reflex correctly in the pupil of the deviating eye.
Brain Electrical Activity Mapping in the Study of Visual Development and Amblyopia in Young Children
Authors: Thouvenin Dominique , Tiberge Michel , Arne Jean-Louis , Arbus Louis
Published: April 2021

ABSTRACT

Brain electrical activity mapping (BEAM) allows the study of electrical visual reactivity on a computerized electroencephalogram (EEG). We carried out 150 BEAM studies on 120 infants to evaluate the usefulness and reliability of this noninvasive technique In the assessment of vision in very young children, compared with other methods (clinical testing, preferential looking, and visual evoked potentials). BEAM demonstrated amblyopia at a cortical level and showed specific electrical signs of amblyopia. The visual reactivity was variably affected depending on the type of amblyopia present. In addition, different results of BEAM corresponded to different kinds of visual maturation delay and strabismus in the absence of amblyopia. BEAM appears to be useful in the initial screening and during treatment of deprivation and strabismic amblyopia, especially when other methods have failed to elicit the level of vision.
Can Adjustable Suture Surgery Be Performed With Conscious Sedation?
Authors: Carruthers Jean D A , Mills Keith , Bagaric Diana
Published: April 2021

ABSTRACT

We retrospectively reviewed the charts of 50 consecutively referred adult patients with horizontal ocular misalignment only. We wanted to evaluate anesthesia by conscious sedation as an alternative to general anesthesia for the primary surgical stage of adjustable suture repair. Parameters regarding patient acceptance, strabismus correction, and health-care facility utilization were studied. Conscious sedation is a safe and effective alternative to general anesthesia for adjustable suture repair of horizontal misalignment in adult patients.
Anterior Transposition of the Inferior Oblique in the Treatment of Unilateral Superior Oblique Palsy
Authors: González Caleb , Cinciripini Grace
Published: April 2021

ABSTRACT

Anterior transposition of the inferior oblique (ATIO), is an accepted surgical procedure for the treatment of primary inferior oblique overaction and dissociated vertical deviation. Our study was undertaken to see if ATIO could be useful in the treatment of preselected unilateral superior oblique palsy (SOP) patients. Three consecutive patients with unilateral SOP with preoperative primary-position hypertropia averaging 27 Δ, Knapp class V, underwent ATlO. The results were excellent and none of these patients developed primary-position hypotropia. Complications of ATIO in our patients consisted of some elevation deficiency, elevation of the lower Hd in upgaze, and reduced inferior "scierai show" in the surgically treated eye. We are proposing that ATIO be considered as a beneficial operation in unilateral SOP patients with at least 25 Δ of preoperative primaryposition hypertropia.
Pseudohypopyon in Acute Myelogeneous Leukemia
Authors: Ellis Anna , Clarke William N , Noel Léon-Paul
Published: April 2021

ABSTRACT

An 11-month-old boy presented with uniocular hypopyon, elevated intraocular pressure, and iris nodules. A differential diagnosis of physical abuse, infection, retinoblastoma, juvenile xanthogranuloma, and histiocytosis X were considered but initial physical and laboratory investigations all had normal results. Three weeks following initial presentation, the child developed fulminant acute myelogenous leukemia. The clinical course, investigations, and outcome are reviewed.
Vertical Shift of the Medial Rectus Muscles in the Treatment of A-Pattern Esotropia: Analysis of Outcome
Authors: deB Ribeiro Geraldo , Brooks Steven E , Archer Steven M , Del Monte Monte A
Published: April 2021

ABSTRACT

A retrospective study was performed on 18 consecutive patients with A-pattern esotropia and no apparent oblique muscle dysfunction, mechanical restriction, paresis, or previous muscle surgery. All patients underwent graded bilateral medial rectus recession for their esotropia with simultaneous vertical upshift to treat the A-pattern. The quantitative relationship between amount of upshift, amount of A-pattern correction, preoperative A-pattern, and preoperative esotropia was examined. We found that the amount of A-pattern correction was closely correlated with the size of the A-pattern preoperatively (r=0.83), independent of amount of upshift. While the change in A-pattern did correlate with the amount of the upshift (r=0.60), it was not a significant independent predictor of the surgical response. The amount of recession had little influence on the effectiveness of the procedure in correcting the vertical incomitance, and the transposition did not seem to affect the correction of the basic esotropia, adversely. We conclude that medial rectus recession with vertical upshift of the muscle insertions is an effective procedure for correcting the vertical incomitance in A-pattern esotropia, and that the amount of A-pattern correction achieved is determined primarily by the size of the preoperative A-pattern and not the amount of upshift.
Botulinum A Toxin Treatment of a Deviated Orbital Implant
Authors: Wortham Edwin , Choi Rosan Y , Young Steven R
Published: April 2021

ABSTRACT

We report a case of progressive deviation of an implant that resulted in conjunctival thinning and an inadequately fit prosthesis. Such a case may have been treated with conjunctival grafting or replacement of the implant with an hydroxyapatite sphere. In this case, injection of botulinum A toxin (Botox) into the contracted medial rectus muscle contributed to the successful refitting of a new and stable prosthesis and improvement of the conjunctival integrity. Possible explanations of the progressive shift in the position of the implant and its postinjection stability are discussed.
Bilateral Monocanalicular Silicone Loop: Predictable Home Removal of Nasolacrimal Stents
Authors: Arnold Robert W
Published: April 2021

ABSTRACT

Premature dislocation, a potential disadvantage of conventional, unilateral silicone intubation for lacrimal disease, can be alleviated with a firmly-tied, bilateral, superior canaliculus intubation. Since the looped silicone stent can be removed easily at home by parents, this technique is particularly beneficial for remote patients for whom postoperative, clinic removal is a financial burden.
Bilateral Infantile Cataractogenesis in a Patient With Deficiency of Complex I, A Mitochondrial Electron Transport Chain Enzyme
Authors: Ciulla Thomas A , North Kathryn , McCabe O'Ine , Anthony Douglas C , Korson Mark S , Petersen Robert A
Published: April 2021

ABSTRACT

Progressive bilateral cataracts developed in infancy in a 5-month-old girl with deficiency of complex I, a mitochondrial electron transport chain enzyme. In the newborn period, she had severe lactic acidosis and the diagnosis of complex I deficiency was confirmed by mitochondrial respiratory chain assay on muscle biopsy. By 5 months, she had completely opaque nuclear sclerotic cataracts, with loss of fixation and the red reflex. She underwent bilateral, sequential cataract extraction. The lens aspirate was submitted for cytologie analysis and electron microscopy, which revealed increased intracellular glycogen and swollen mitochondria. To our knowledge the association of complex I deficiency with cataracts in infancy has not been reported previously. The diagnosis of a respiratory chain enzyme defect in infancy is an indication for early ophthalmic evaluation to identify cataracts that may result in visual loss. Conversely, the recognition of cataracts in infants with unexplained neurologic disease or metabolic acidosis may necessitate further evaluation for metabolic etiologies, including mitochondrial disorders.
Infant Random Dot Stereoacuity Cards
Authors: Birch Eileen E , Salomão Solange
Published: April 2021

ABSTRACT

Purpose: The overall goal was to develop a simple test of random dot Stereoacuity that can be used during the first 24 months of life to measure sensory outcomes following treatment of ophthal moped iatric disorders, both in the context of clinical trials and in the context of clinical management.

Methods: A series of random dot Stereoacuity test cards were constructed using vectographic vertical bar stimuli with crossed disparities ranging from 1735 to 45 sec. A two-alternative, forced-choice, preferential-looking test protocol was used to measure Stereoacuity in 95 healthy term infants (173 tests) over the 1.5- to-24-month age range. Success rate, validity, and tolerance limits for normal performance as a function of age were evaluated.

Results: Jhe success rate was high (158 of 173 tests; 91.3%). The maturation of random dot Stereoacuity was similar to that measured In earlier lab-based preferentiallooking and visual evoked potential protocols; few Infants younger than 2 months of age demonstrated stereopsls although by 12 months, mean Stereoacuity was 2.1 log sec (120 sec). A further improvement to 1.7 log sec (56 sec) was seen during months 18 to 24, consistent with data obtained in an earlier opérant random dot protocol. Tolerance limits for normal ranged from approximately 1000 sec at 6 months to 100 sec after 12 months.

Conclusions :ihe Infant random dot Stereoacuity cards provide a simple, quick, and portable preferential-looking test of random dot Stereoacuity for infants that has a high success rate and excellent concordance with Stereoacuity outcomes from laboratory-based protocols.
Evaluation of a Hand-held Autorefractor in Children Younger Than 6
Authors: El-Defrawy Sherif , Clarke William N , Belec France , Pham Ba
Published: April 2021

ABSTRACT

Purpose; To evaluate a hand-held portable a uto refractor in a pediatrie population and compare results with those found on retinoscopy by experienced pediatrie retinoscopists.

Methods: One-hundred and two children aged 5 to 72 months were examined with and without cycloplegia using an autorefractor, and the results compared with those found on standard retinoscopy by two ophthalmologists masked as to the autorefractor findings. Results were converted from conventional notation using plus cylinder to the h-space notation and compared in threedimensional h-space.

Results: There was remarkable agreement between the results found by autorefraction and manual retinoscopy using loose lenses or a phoropter.The findings were similar both for sphere and cylinder across the age ranges studied.

Conclusions: The Nikon Retinomax is an accurate instrument to estimate refractive error in children younger than 6 and could prove useful in the office, the operating room, or as a screening device.