bluuebunny/crossref_metadata_2025 huggingface dataset:
Near Retinoscopy in Accommodative Esotropia
Authors: e Cruz Antonio Augusto Velasco , Sampaio Niumara Maria Veitas , Vargas José Amadeu
Published: April 2021

ABSTRACT

We tested whether near retinoscopy, a noncycloplegic retinoscopic technique, was applicable to the optic correction of patients with accommodative esodeviations. We performed a study in 17 patients with accommodative esotropia to compare the refractive values obtained by near retinoscopy and by cycloplegia, as measured by two examiners.

The interobserver variability was the same for the two techniques for the refractive values of the horizontal and vertical me rid i a and spherical equivalent. For the astigmatism, there was greater variability for near retinoscopy. The correlation between the two methods was good, but the variability of the differences was high.

We recommend that near retinoscopy should be employed only as a noninvasive method for screening refractive errors in children.
Endophytic vs Exophytic Unilateral Retinoblastoma: Is There Any Real Difference?
Authors: Palazzi Maristela , Abramson David H , Ellsworth Robert M
Published: April 2021

ABSTRACT

A retrospective review of 297 cases of enucleated and histologically proven unilateral retinoblastoma with a minimum of 5-year follow-up was analyzed to see if there were any clinical or prognostic differences between endophytic and exophytic type retinoblastoma. Endophytic retinoblastoma (181 cases) was found more often than exophytic (116 cases).

The following features were not associated with the clinical appearance of either endophytic or exophytic tumors: sex of patient, right vs left eye, propensity for bilateral development, initial sign or symptom, presence of rubeosis, preoperative metastasis, optic nerve invasion, orbital recurrence, survival of the patient, length of follow-up, or age at diagnosis.

Three features were found that correlated with type: a disproportionately higher percentage of patients with endophytic retinoblastoma had a positive family history; a disproportionately high percentage of patients with exophytic retinoblastoma developed glaucoma; and choroidal invasion occurred significantly more often in patients who had exophytic retinoblastoma than in those who had endophytic retinoblastoma.
Retinopathy of Prematurity: The Relationship With Intraventricular Hemorrhage and Bronchopulmonary Dysplasia
Authors: Brown David R , Biglan Albert W , Stretavsky Marinda M A
Published: April 2021

ABSTRACT

We studied prospectively a cohort of 326 neonates weighing 500-1250 gm at birth. These babies were all born at Magee-Womens Hospital during 1986 and 1987. Sixty-five percent survived and were discharged from the hospital, and 197 of the survivors (93%) had at least one ophthalmological exam before their discharge. Of the patients who were examined, 34% had retinopathy of prematurity (ROP) and 12% had stage 3 or 4 ROP in at least one eye. There were six neonates with at least one blind eye, giving an estimated prevalence of blindness caused by ROP of 301 per million live births. By univariate analysis there was a strong association of ROP with birthweight, oxygen exposure, respirator treatment, and intraventricular hemorrhage (IVH). By multivariate analysis, only the respirator treatment was significantly associated with ROP. When birthweight, oxygen exposure, and IVH were controlled, a baby requiring more than 28 days of ventilator treatment was 4.07 times more likely to have stage 3 or 4 ROP than a baby with less ventilator exposure. These data confirm the strong association of ROP with bronchopulmonary dysplasia (BPD), low birthweight, and IVH, and suggest that the key component among these interrelated variables may be time spent on a ventilator.
Clinical Variations of Trilateral Retinoblastoma: A Report of 13 Cases
Authors: De Potter Patrick , Shields Carol L , Shields Jerry A
Published: April 2021

ABSTRACT

Of 440 consecutive children with retinoblastoma whom we treated between April 1972 and April 1992, 13 (3%) developed a midline intracranial neoplasm. Four of these 13 patients had bilateral familial retinoblastoma, 7 had bilateral sporadic retinoblastoma, and 1 patient had unilateral familial retinoblastoma. The twin brother of the latter patient developed pinealoblastoma without retinoblastoma. In this series, the incidence of trilateral retinoblastoma was 8% of all bilateral familial retinoblastoma and 5% of all bilateral sporadic retinoblastoma. The retinoblastoma was diagnosed at a mean age of 4.5 months and the midline intracranial tumor was diagnosed at a mean age of 23 months. The mean time interval between the diagnosis of retinoblastoma and the intracranial tumor was 22 months (range, 0 to 48 months). Seven patients (55%) were asymptomatic and their intracranial neoplasm was found on routine brainimaging studies. The primary intracranial neoplasm had a pineal location in 10 cases and parasellar location in three cases. Despite aggressive combined treatment, 12 patients (92%) have died at a mean interval of 11 months after the diagnosis of intracranial malignancy. The mean survival of patients with midline intracranial neoplasm who were asymptomatic was significantly longer than that of symptomatic patients (P = .05). Because an early diagnosis of the intracranial neoplasm is statistically associated with longer survival and despite the high cost of brain-imaging studies, we usually recommend that children with bilateral and/or familial retinoblastoma until age 4 years undergo regular contrast-enhanced magnetic resonance imaging of the brain to detect asymptomatic early pineal and parasellar tumors.
Leber Congenital Amaurosis and Its Association With Keratoconus and Keratoglobus
Authors: Elder Mark J
Published: April 2021

ABSTRACT

Leber congenital amaurosis has been associated with keratoconus and it has been postulated that this is due to eye rubbing, the oculo-digital sign, because of poor vision. Six schools for the blind were visited, and 174 children with a visual acuity of less than 3/60 examined. Thirty-five children had Leber amaurosis, and 10 of these had keratoconus (29%) and one had keratoglobus (3%). The six pedigrees of the cases with Leber amaurosis and keratoconus are presented in detail. Only 3 of the 139 other blind children had keratoconus (P<.05) and 1 had keratoglobus. Keratoconus seems specifically associated with Leber amaurosis, probably due to genetic factors, rather than poor visual acuity per se.
Posterior Chamber Lens Implantation for Primary Repair of Corneal Lacerations and Traumatic Cataracts in Children
Authors: Anwar Mohammed , Bleik Jamal H , von Noorden Gunter K , El-Maghraby Akef A , Attia Fadia
Published: April 2021

ABSTRACT

Children older than 3 years of age rarely tolerate contact lenses for unilateral surgical aphakia. This problem is even more pronounced following repair of corneal lacerations or perforations that are associated with traumatic cataracts. Even if surgery is successful, such eyes are functionally doomed because of deep anisometropic amblyopia. We evaluated prospectively in 15 children (3 to 8 years) the results of combined operation of corneal repair, aspiration of traumatic cataract, and primary posterior chamber lens implantation. Postoperative occlusion treatment was carefully monitored. Follow up ranged from 6 to 60 months, with an average of 39.2 months. The final best corrected visual acuity at the patient's last visit was 20/40 or better in 11 of 1 5 children (73.3%). The most frequent complication was a nonfunctional pupil due to traumatic iris damage or posterior synechiae in 13 cases. The most visually significant complication was posterior membrane formation and/or posterior capsule opaclf ication, which required additional surgeries in six children.
Quantitative Magnetic Resonance Morphometry of Extraocular Muscles: A New Diagnostic Tool in Paralytic Strabismus
Authors: Demer Joseph L , Miller Joel M , Koo Edward Y , Rosenbaum Arthur L
Published: April 2021

ABSTRACT

Paralytic strabismus is often diagnosticai Iy ambiguous due to the similarity of patterns of misalignment produced by different mechanisms. To address this problem, we have developed a new technique employing high-resolution, surface coil magnetic resonance imaging to quantify extraocular muscle size and contractility. Adjacent coronal images are obtained spanning the anteroposterior extent of each orbit, and repeated in multiple directions of gaze. Contractility is evaluated from analysis of muscle cross-sectional areas.

The quantitative size and contractile characteristics of normal rectus and superior oblique muscles are reviewed, along with the effects of superior oblique palsy. The morphometric features of lateral rectus palsy are illustrated by three clinical cases exhibiting deficient contractility and atrophy of the lateral rectus muscle. A case of superior oblique palsy Is presented illustrating atrophy and lack of contractility of the involved superior oblique muscle.

This imaging technique can be employed in any clinical center and permits insight into extraocular muscle function in complex strabismus cases.
VECP Evidence for Binocular Function in Infantile Esotropia
Authors: France Thomas D , Ver Hoeve James N
Published: April 2021

ABSTRACT

Since commonly used clinical methods of measuring binocular function require subjective responses, this testing has been limited to more cooperative children, usually older than 2 years of age. Recently, we have begun using a clinically practical, visually evoked cortical potential (VECP) method to detect the presence of binocular neurons in infants and young children.

We studied 14 children, ages 4 to 44 months, with infantile esotropia. Nine had surgical correction for esotropia by the age of 2 years. Twenty-five normal infants ages 6 weeks to 22 months served as controls.

Most normal infants showed the development of the "beat" by 2 months of age. The "sum" VECP was not consistently present until age 6 months.

Four of the five esotropic infants less than 1 year of age, demonstrated neither a "sum" nor "beat" response.

All nine patients with corrective surgery performed before 2 years of age developed a significant sum response and three developed a beat. Five patients had not had surgery until after 2 years of age. Two developed a sum and one a beat, but none had both beat and sum responses.

The results suggest that there is a loss of nonlinear binocular response in esotropic children not corrected before the age of 2 years and that these responses can be restored after early treatment even if not present at the time of surgery.
Ocular Pursuit Movement Assessment by Magnetic Resonance Imaging
Authors: Cadera Werner , Karlik Stephen J , Viirre Erik , Bloom Jeffrey N
Published: April 2021

ABSTRACT

We describe a new technique for generating cinematic magnetic resonance images. This method produces more physiological imaging of extraocular muscles than our previous method. In addition, this technique provides more comfort for the study subject and results in less head movement artifact.
Dichoptic Luminance Beat Visual Evoked Potentials in the Assessment of Binocularity in Children
Authors: Stevens Julia L , Berman Jeffrey L , Schmeisser Elmar T , Baker Robert S
Published: April 2021

ABSTRACT

Direct evidence of a distinct cortical binocular pathway has been provided by the production of nonlinear (difference) beats from dichoptic luminance stimulation in stereonormal adults and the absence or diminution of these beats in stereoblind subjects. We have investigated a clinically useful application of this technique in a pediatric population with potentially abnormal binocular vision. We recorded dichoptic luminance beat visual evoked potentials (VEPs) from 20 children (ages 7 months to 8 years) with abnormal binocular ability secondary to strabismus and/or amblyopia and compared this to a control group of 20 children with normal binocularity. Stereoblind children generated significantly lower dichoptic signal-to-noise ratios than stereonormal children (P < .001). Responses to monoptic multifrequency flicker were not significantly different between the two groups (P = .936). This dichoptic VEP can be performed quickly and easily on young children and gives a quantitative assessment of cortical binocularity that may not be determinable by standard clinical methods. This technique may also prove useful for the preoperative gradation of binocular potential and prediction of postoperative binocular fusion.
Exaggerated Effect of Bilateral Medial Rectus Recession in Developmentally Delayed Children
Authors: Pickering J Dawn , Simon John W , Lininger Lloyd L , Melsopp Karin B , Pinto Gregory L
Published: April 2021

ABSTRACT

Many have suggested that the esotropia associated with developmental delay should be considered separately. However, the esotropia surgery recommended for developmentally delayed children has been similar to that performed in normal children. We have noticed a tendency for developmentally delayed children to develop consecutive exotropia following bilateral medial rectus recessions. Of 94 children undergoing such surgery between 1981 and 1991, 31 were developmentally delayed. Follow up ranged from 7 months to 202 months (mean 24 months). Surgical effect, defined as the change in alignment following each amount of surgery, was greater in the developmentally delayed group than in control subjects (P = .002). The increase in effect of the same amount of surgery in a developmentally delayed patient averaged 5.28 prism diopters, but was much larger in specific instances. Variability of effect was more marked among developmentally delayed children. We conclude that bilateral medial rectus recessions in developmentally delayed children may be better postponed in some cases, deferred for smaller angles, or decreased in amount.
Acquired Central Fusion Disruption Following Cataract Extraction
Authors: Sharkey James A , Sellar P William
Published: April 2021

ABSTRACT

Central sensory and motor fusion of images, once established, is usually maintained throughout life. Under certain circumstances, this ability may be lost. This gives rise to the syndrome known as horror fusionis, or acquired disruption of central fusion. We report the development of central fusion disruption in three patients with uniocular mature senile cataract. We postulate that this is the result of prolonged sensory deprivation in the cataractous eye. The loss of fusion results in a particularly troublesome type of intractable diplopia, characterized by the inability to either fuse or suppress images. To the best of the authors' knowledge, this is the first report of central fusion disruption following cataract surgery for senile cataract.
Outcome of Sixth Nerve Palsy or Paresis in Young Children
Authors: Aroichane Maryam , Repka Michael X
Published: April 2021

ABSTRACT

This study evaluated the ophthalmological outcome following sixth nerve palsy or paresis in 64 children 7 years of age and younger. The outcomes considered were vision, residual strabismus and the need for strabismus surgery. Etiologies included tumor, hydrocephalus, trauma, infection, malformation, and idiopathic and miscellaneous causes. Strabismus surgery was performed on 24% of the patients, with residual strabismus present in 66% of the patients. Neurologists and ophthalmologists should monitor visual acuity in these young children at frequent intervals be prepared to institute amblyopia therapy early in the course of the ocular misalignment if permanent visual disability is to be avoided.
Effectiveness of Inferior Transposition of the Horizontal Rectus Muscles for Acquired Inferior Rectus Paresis
Authors: Burke John P , Keech Ronald V
Published: April 2021

ABSTRACT

Full inferior transposition of the horizontal recti (inverse Knapp procedure) was performed on four patients with unilateral inferior rectus muscle weakness. The patients were followed up over time to determine the medium- and long-term effectiveness of the procedure. All of the patients had single binocular vision without the use of prisms in the primary position of gaze and three in the reading position after a mean postoperative followup interval of 2V2 years. The mean primary position preoperative vertical deviation was 20.3 Δ and the mean primary position postoperative vertical correction was 19.5 (range, 16 to 24) Δ. The field of binocular single vision was assessed quantitatively and scored 2.4% preoperatively compared with 52.3% postoperatively. There was no decrease in the effect of the procedure over time. Additional surgery may still be required to correct symptomatic residual vertical down-gaze diplopia.
Brown's Syndrome With Cyclic Characteristic: Case Report and Review of Physiopathologic Mechanism
Authors: Can Izzet , Yarangüeli Alper , Kural Gülcan
Published: April 2021

ABSTRACT

This article reports on an acquired Brown's syndrome case presenting with cyclic characteristics. Restriction of elevation in adduction was observed in the right eye of a 15-year-old boy who had been referred with a complaint of diplopia that occurred on waking in the morning and continuing until noon. The same situation was noted following afternoon naps. The patient was able to improve his complaint by performing a forced elevation in adduction while massaging his right trochlear region and the restriction did not recur until the next morning.
Retinal Detachment in a Child as the First Sign of Leukemic Relapse: Histopathology, MRI Findings, Treatment, and Tumor-free Follow Up
Authors: Brei Timothy J , Burke Miles J , Rubinstein Jack H
Published: April 2021

ABSTRACT

Improved leukemia therapies in children have brought about prolonged remissions with extramedullary relapses being reported in sites other than the most common (bone marrow, testes, brain, and spinal cord). A 3-½year-old boy with a history of acute lymphocytic leukemia presented with total retinal detachment in one eye. Painful glaucoma unresponsive to medical therapy necessitated enucleation. Histopathologic examination documented the presence of a dense leukemic cellular infiltrate replacing a totally detached, necrotic retina. Tumor cells also were present in the optic nerve. The child had remained free of leukemia for 3 years after systemic and intrathecal chemotherapy, supplemented by craniospinal radiation. This represents the first case of relapse of acute lymphocytic leukemia presenting solely as a retinal detachment. Our case also underscores the point that the treatment of leukemia after an isolated ocular relapse can be associated with a favorable outcome.
Photoscreening for Amblyogenic Factors
Authors: Ottar Wanda L , Scott William E , Holgado Sandra I
Published: April 2021

ABSTRACT

Background: The Medical Technology Ine (MTI) Photoscreener™ is a new eccentric photoscreener that Is being marketed as a device for the detection of amblyogenic factors in preverbal children. The purpose of this study was to evaluate the accuracy of the MTI Photoscreener11' in the target population of young, healthy children.

Methods: One thousand and three healthy children between the age of 6 months and 59 months were photoscreened with the MTI Photoscreener™. Nine hundred and forty nine children were included in the study and their results were compared with a complete ophthalmologic examination with cycloplegia.

Results: The sensitivity of the MTI Photoscreener™ was determined to be 81.8% with a specificity of 90.6%. The overall agreement rate was 88.8%. The positive and negative predictive values were 68.9% and 95.2%, respectively. All cases of strabismus and media opacities were detected.

Conclusion: The MTI Photoscreener™ is an accurate and reliable device designed to detect amblyogenic factors in young children. The camera offers promise as a useful mass-screening tool.
Prevalence of Intracranial Lesions in Children Initially Diagnosed With Disconjugate Nystagmus (Spasmus Nutans)
Authors: Arnoldi Kyle A , Tychsen Lawrence
Published: April 2021

ABSTRACT

A small number of children who develop disconjugate nystagmus, torticollis, and head titubation (spasmus nutans) have been found to have optic chiasm or third ventricle gliomas. However, the prevalence of glioma or other developmental abnormalities in this disorder is unknown because no large series of spasmus nutans cases has previously been reported. A reviewer of the records of 67 consecutive children initially diagnosed with spasmus nutans and followed for an average of 3.3 years at the St Louis Children's Hospital revealed the following: 61% had a history of prematurity, developmental delay, or other systemic abnormality; strabismus, most commonly infantile esotropia, developed in 55%; 43% had neuroimaging studies; and 0% had evidence of a glioma or showed signs of tumor on follow-up examinations. From this consecutive patient series, we estimate the prevalence of tumor in spasmus nutans to be less than 1.4%. Without other evidence of an intracranial mass lesion, neuroimaging of infants initially diagnosed with spasmus nutans may not be immediately warranted.
Treatment of Retinoblastoma With Indirect Ophthalmoscope Laser Photocoagulation
Authors: Shields Carol L , Shields Jerry A , Kiratli Hayyam , De Potter Patrick V
Published: April 2021

ABSTRACT

Introduction: The indirect ophthalmoscope laser photocoagulation delivery system is relatively new and is potentially applicable for treating selected small retinoblastomas. There has been very little reported on the results achieved with this laser delivery system in the treatment of retinoblastoma.

Methods: We reviewed all patients with retinoblastoma managed by indirect ophthalmoscope laser photocoagulation on the Ocular Oncology Service between July 1, 1991 and July 1, 1994. The individual tumor size, location, and proximity to the optic disc and foveola, as well as the laser power, duration, and number of sessions, were recorded. We assessed the tumor response to treatment and the visual outcome of the patients.

Results: There were 30 retinoblastomas in 20 eyes of 18 patients managed with indirect ophthalmoscope laser photocoagulation over the 3-year period. The mean tumor base was 2.1 mm (range: 1 mm to 8 mm); the mean tumor thickness, 1.2 mm (range: 0 mm to 3 mm). The tumor margin was a mean of 6.5 mm (range: 0 mm to 19 mm) from the foveola, and 7.7 mm (range: 0 mm to 22 mm) to the optic disc. In general, it required a power of approximately 350 mW and a continuous duration lasting 1 to 4 seconds to obtain satisfactory obliteration of feeding blood vessels. The tumor responded in one to three sessions (mean: 1.9 sessions per tumor). Complete regression occurred in 21 tumors (70%) and local recurrence in nine (30%). The recurrent tumors were successfully treated with plaque radiotherapy in seven cases and cryotherapy in two cases. The central vision was minimally distorted due to foveal traction from the laser treatment in three cases.

Conclusion: Indirect ophthalmoscope laser photocoagulation is an effective conservative method to manage selected small retinoblastomas. Tumors treated by this technique should be followed closely due to the moderate risk for local recurrence.
The Surgical Correction of Paralytic Strabismus Using Fascia Lata
Authors: Salazar-León José A , Ramírez-Ortíz Marco A , Salas-Vargas Marisela
Published: April 2021

ABSTRACT

Objective: To present the results of a new technique designed to restore and maintain alignment, exclusively In the primary position, in patients with paralytic strabismus.

Methods: In five patients (seven eyes, total) with exotropia secondary to third-nerve palsy, we fixated the globe with a strip of fascia lata sutured onto both the medial aspect of the eye and the nasal bone periosteum. We characterized the ocular deviation in the primary position with prism diopters the day before the operation, during the initial 24-hour period, and at subsequent monthly postoperative evaluations. We documented all evaluations with photographs.

Results: In all patients, the ocular position improved with the surgery. No further change of the ocular position was noted during the follow-up period, which ranged from 15 to 35 months (mean follow up 22.5 months). All the patients tolerated the collagenous tissue without complications.

Conclusions: This procedure can be a useful addition to the current surgical techniques for management of strabismus secondary to third-nerve paralysis.
Screening for Uveitis in Juvenile Rheumatoid Arthritis
Authors: Boone Michael I , Moore Terry L , Cruz Oscar A
Published: April 2021

ABSTRACT

Background: Uveitis associated with juvenile rheumatoid arthritis (JRA) is an important cause of visual impairment in children. Because uveitis is often asymptomatic in this age group, frequent ophthalmologic screening examinations are recommended. Recent reports have found a decrease in the prevalence and severity of uveitis in JRA when compared to older data.

Methods: The charts of 52 consecutive patients with JRA seen over a 30-month period were retrospectively reviewed.

Results: Eye examination identified uveitis in five (12%) patients. All patients with uveitis were female, ANA positive, and had pauciarticular-onset arthritis. Three patients had the onset of uveitis before the age of 2. AM patients have maintained good visual acuity and have not developed serious sight-threatening ocular complications over the follow-up period.

Conclusions: Although the prevalence and severity of JRA-associated uveitis may be decreasing, we strongly recommend continued strict adherence to the current screening guidelines.
Clinical Practice Guidelines for the Management of Orbital Cellulitis
Authors: Uzcátegui Nicolás , Warman Roberto , Smith Alfred , Howard Cleve W
Published: April 2021

ABSTRACT

Purpose: A retrospective study was performed to review the management of periorbital and orbital cellulitis at Miami Children's Hospital, between January 1, 1993 and February 15, 1996.

Resufts: One hundred and one patients were included in this study. The variables analyzed in this study included age, sex, length of hospital stay, imaging studies, laboratory tests, and microbiology specimens collected. Patients were classified according to the modified Chandler classification. Average length of stay for our patient population was 4.5 days. Data regarding the radiologie studies, laboratory tests, and microbiology yield of specimens were analyzed.

Conclusions: The incidence of orbital infection, manifested by lid swelling alone is much more common (stages I and II) than orbital infection involving postseptal findings (stages III, IV, and V); 84.16% compared with 15.84%, respectively. An updated approach and a general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.
Surgical Technique, Visual Outcome, and Complications of Pediatric Intraocular Lens Implantation
Authors: Simons Brad D , Siatkowski R Michael , Schiffman Joyce C , Flynn John T , Capó Hilda , Muñoz Michelle
Published: April 2021

ABSTRACT

Purpose: To evaluate retrospectively the surgical technique, visual outcome, and complications of pediatric cataract extraction (CE) and intraocular lens (IOL) implantation.

Methods: Forty-three patients ages 2 to 12 underwent CE with IOL implantation with a minimum follow up of 1 month.

Results: All IOLs were implanted in the posterior chamber with 17 (40%) in the bag, 25 (58%) sulcus fixated, and one (2%) partially in the bag (one haptic in the bag, one in the sulcus). Primary posterior capsulectomy was performed in 12 (28%) cases. A final visual acuity of at least 20/40 was achieved in 26 (60%) and at least 20/80 in 32 (74%). Posterior capsule opacification developed in 18 (42%) and pupillary capture in 7 (16%). Seventeen (40%) patients had postoperative visual acuity worse than 20/40. Of these, nine (53%) had this visual outcome as a result of presumed amblyopia.

Conclusions: Posterior chamber IOL implantation affords a safe and effective method of visual rehabilitation for cataractous children 2 years of age and older. Amblyopia and antecedent posterior segment trauma, rather than IOL-related or surgical complications, are the limiting factors in final visual outcome.

Journal of Pediatric Ophthalmology & Strabismus 1999; 36:118-124.
Intraocular Lens Implantation in Children and Youth
Authors: Malukiewicz-Wisniewska Grazyna , Kaluzny Józef , Lesiewska-Junk Hanna , Eliks Iwona
Published: April 2021

ABSTRACT

Purpose: To evaluate the safety and the effectiveness posterior chamber intraocular lenses (PCIOLs) in children and youth with cataract.

Methods: Retrospective study of operative and postoperative results was based on 146 eyes in 125 children ages 6 to 18 years (mean: 11.7 years) who underwent extracapsular cataract extraction with IOL implantation in the period from 1986 to 1996. Follow up was 1 to 10 years.

Outcome measure: Best corrected distance and near visual acuity, operative complications, and early and late postoperative complications. Exclusion criteria were uveitis, retinal detachment, prior glaucoma, and systemic diseases.

Results: Early postoperative complications were observed in 12.3% of cases including iritis in 7.5%, and transient corneal edema in 3.4% of eyes. Posterior capsule opacification requiring capsulotomy was needed in 81.5% of eyes after 8.5 years. YAG laser capsulotomy was performed in 68.1% and surgical intervention in 26.8% of cases. In 5.1% of the cases, both techniques were used. In 74.7% of patients, best corrected visual acuity of 0.5 or better was achieved. The mean postoperative spherical equivalent was +0.35 diopters (D, SD 1.35). Spectacle-corrected near visual acuity of 0.5 on the Snellen chart was obtained in 82.8% of eyes.

Conclusion: IOL implantation in children older than 6 years appears to be an efficacious, satisfactory, and safe procedure in the management of pediatric cataract.

Journal of Pediatric Ophthalmology and Strabismus 1999;36:129-133.
Strabismus Surgery Using the Adjustable Suture Technique
Authors: Wygnanski-Jaffe Tamara , Wysanbeek Yigal , Bessler Emanuel , Spierer Abraham
Published: April 2021

ABSTRACT

Background and Objective: To determine the results of adjustable suture technique used in horizontal muscle surgery.

Materials and Methods: Seventy-eight charts of patients who underwent strabismus surgery between the years 1993 and 1995 were examined retrospectively. The study included 35 cases of esotropia (ET), and 43 cases of exotropia (XT). The results of strabismus surgery were measured and compared 1 day after adjustment; the final results between 6 and 24 months after the surgical procedure.

Results: Adjustment was required in 39% of all patients. The highest rate of adjustment was required in patients who underwent monocular surgery for XT (51%), and the lowest rate of adjustment was undertaken in patients who underwent monocular surgery for ET (16%). Mean changes in the angle of deviation between 1 day after surgery to the last follow up was 2.2 prism diopters (?) (±11.2 ?) for cases of esotropia, and 4.6 ? (±8.7 ?) for exotropia. The most significant drift was found in patients with XT who underwent binocular surgery 6.8 ? (±0.9 ?) and the smallest drift was found in patients with ET who underwent binocular surgery 5.2 ? (±5. 6 ?).

Conclusion: Esotropie and exotropic patients have a tendency to drift towards their original deviation postoperatively. It is possible, therefore, that mild overcorrection in the early postoperative period will result in better long-term results.

Journal of Pediatrie Ophthalmology and Strabismus 1999;36:184-188.
A Randomized Comparison of Prism Adaptation and Augmented Surgery in the Surgical Management of Esotropia Associated With Hypermetropia
Authors: Hwang Jeong-Min , Min Byung-Moo , Park Soo-Chul , Oh Sei Yeul
Published: April 2021

ABSTRACT

Objective: To compare both motor and sensory surgical outcomes for patients with esotropia associated with hypermetropia managed with an augmented surgery based on the average of the near deviation with and without correction vs preoperative prism adaptation.

Methods: Forty-three patients with esotropia associated with hypermetropia entered a randomized prospective evaluation of augmented surgery (group A, 27 patients) versus prism adaptation (group P, 16 patients). The formula for augmenting the amount of the rectus muscle recession was based on the average of the near deviation with and without correction in group A, and the prism-adapted angle of deviation in group P.

Results: In group A, postoperative deviations of 8 prism diopters (Δ) or less at distance and at near were achieved in 24 patients (88%), and in 22 patients (81%), respectively. In nine prism responder patients, postoperative deviations of 8 Δ or less at distance and at near were achieved in eight patients (89%). In seven nonresponder patients, postoperative deviations of 8 Δ or less at distance and at near were achieved in six patients (86%). No significant difference between the two groups in terms of near and distance deviation at 1 and 3 months postoperatively were noted.

Conclusion: No significant difference existed in the motor outcomes between the two groups, or between the prism responder and prism nonresponder groups. Further detailed studies must be made in a large number of patients.

Journal of Pediatric Ophthalmology and Strabismus 1999;36:196-200.
Long-term Results of Bimedial Rectus Recessions in Infantile Esotropia
Authors: Tolun Hayati , Dikici Kemal , Ozkiris Abdullah
Published: April 2021

ABSTRACT

Background: Congenital esotropia has a deviation of 50 or more prism diopters (Δ). Generally, surgical alignment of the eyes is the accepted treatment but surgical techniques differ.

Methods: A total of 54 patients were evaluated. Surgery was done at a mean age of 28 months. Bimedial rectus recessions up to 8 mm were performed.

Results: The mean preoperative deviation was 70 Δ of esotropia. Our success rate with a uniform approach was 66.6%.

Conclusions: Contrary to the selective approach for large angle congenital esotropia, we do not consider initial surgery on three or more muscles. Our method is quicker, simpler, less traumatic, and leaves the lateral rectus muscles unoperated for patients requiring a second surgery.

Journal of Pediatric Ophthalmology and Strabismus 1999;36:201-205.
Ophthalmologic Screening of Deaf Students in Oregon
Authors: Brinks Mitchell V , Murphey William H , Cardwell William , Otos Maurine , Weleber Richard G
Published: April 2021

ABSTRACT

Purpose: To determine the frequency of Usher's syndrome and other ocular disease in students receiving special education services for the deaf in Oregon and to assess the amount of existing ophthalmologic surveillance of this population. A special emphasis was placed on screening for Usher's syndrome.

Methods: From 1980-1990, a prospective twocenter visual screening program of 231 deaf students in schools throughout Oregon was conducted using an ophthalmic questionnaire, complete eye examinations, and electroretinography. Students were between the ages of 10 and 21 years and participated on a volunteer basis. Findings for etiology and severity of visual loss and the scope of ophthalmologic surveillance within this population were analyzed.

Results: Two hundred seventeen of the 231 students examined received electroretinograms. Significant ocular pathology was found in 1 1 1 (48%) of the students. The most common diagnoses were congenital rubella (21%), significant uncorrected ametropia (16%), and ocular hypertension (9%). Five students were diagnosed with Usher's syndrome. Of the students with significant ocular pathology, only 37% were actively followed by an ophthalmologist.

Conclusion: Deaf students in Oregon's schools had a high frequency of eye disease. Early diagnosis and treatment of eye disease in this population could benefit the quality of life of these students. This study alerted the providers of special education services for the deaf and the ophthalmologic community in Oregon of the need for better eye care for these students.

Journal of Pediatric Ophthalmology and Strabismus 2001 ;38:1 1 -1 5.
Checklist for the Evaluation of Low Vision in Uncooperative Patients
Authors: Salati Roberto , Schiavulli Ornella , Giammari Giuseppina , Borgatti Renato
Published: April 2021

ABSTRACT

Purpose: To present a checklist for the evaluation of low vision in uncooperative patients; in this specific case, children with neuroEogicai deficits.

Method: The checklist includes several behavioral indicators obtainable with a standard clinical examination. Each test is assigned a score (0=failure, ]=success). The final visual quotient score is obtained by dividing the partial score by the total number of tests performed. Eleven children with cerebral visual impairment were studied using behavioral and preferential looking techniques.

Results: Visual quotient was >0 in all patients, indicating that residual visual function was always detectable. Average visual quotient was 0.74.

Conclusion: Visual quotient can be useful both for follow-up examinations and comparison and integration with other evaluation methods (behavioral and instrumental) of residual visual capacity. In particular, if combined with preferential looking techniques, visual quotient testing permits characterization of the entire spectrum of low vision.

Journal of Pediatrie Ophthalmology and Strabismus 20(?;38:90-94.
Near-Work Activity and Myopia in Rural and Urban Schoolchildren in China
Authors: Saw Seang-Mei , Hong Rong-Zhao , Zhang Ming-Zhi , Fu Zhi-Fu , Ye Mei , Tan Donald , Chew Sek-Jin
Published: April 2021

ABSTRACT

Purpose: To examine the prevalence of myopia in rural and urban schoolchildren in Xiamen, China, and to assess the impact of environmental factors on rates of myopia.

Methods: Second-grade children attending either a city (n=1 79) or rural (n=91) school in Xiamen, China, were examined using cycloplegic autorefraction and biometry. Detailed questions on socioeconomic status, near-work activity, reading and writing habits, and family histories of myopia were asked in a face-to-face interview using a standard questionnaire.

Results: The prevalence of myopia was 1 9.3% (95% confidence interval [Cl], 12.3, 29) in the city and 6.6% (95% Cl, 2.4, 14.3) in the countryside. The average hours per day children spent reading and writing outside of school was 2.2 hours in the city compared with 1.6 hours in the countryside (P<.0001). In both schools, the odds ratio for total reading and writing adjusted for parental history of myopia, was 2.2 (95% Cl, 1 .1, 4).

Conclusion: These data suggest the prevalence of myopia is higher in the city than in the countryside. One possible explanation for these different rates could be that schoolchildren in the city spend more time reading and writing outside of school compared with children in the countryside. Myopic children in both the city and the countryside spent more time reading and writing compared with nonmyopic children. This increased near-work activity may contribute to the prevalence of myopia.

Journal of Pediatric Ophthalmology and Strabismus 2001;38:149-155.
Ocular and Clinical Manifestations of Möbius' Syndrome
Authors: Cronemberger Mônica Fialho , Moreira José Belmiro de Castro , Brunoni Décio , Mendonça Tomás Scalamandre , Alvarenga Eliézia Helena de Lima , Rizzo Ana Maria Pfeifer Pereira , Diogo Sandra Maria Martins
Published: April 2021

ABSTRACT

Purpose: To assess ocular and otorhinolaryngologic manifestations and intellectual ability in patients with Möbius' syndrome.

Methods: Patients with Möbius' syndrome underwent prospective ophthalmic, genetic-clinical, and otorhinolaryngologic examinations as well as psychological evaluation.

Results: Sixteen patients with Möbius' syndrome between the ages of 8 months and 10.6 years underwent ocular examination. Esotropia was present in 12 (75%) patients and V-pattern in 8 (50%). Limited abduction was present in 30 (93.8%) eyes, and limited adduction was present in 21 (65.6%) eyes. The most frequent refractive error was compound hyperopic astigmatism (13 [40.6%] eyes). Eleven (68.8%) patients had lagophthalmos and 12 (75%) patients had bilateral epicanthus. Unilateral amblyopia was present in 2 (12.5%) patients. Clubfoot was the most common lower limb defect (7 [43.8%] patients). Cranial nerve impairments included paralysis of 7th nerve in all patients, paralysis of the 12th nerve in 13 patients, and paralysis of the 9th and 10th nerves in 3 patients. Evaluation of intellectual ability showed that 4 (25%) patients had normal intelligence. The mothers of 3 (1 8.8%) patients used misoprostol during the first trimester of pregnancy.

Conclusion: Prominent ophthalmic features of Möbius' syndrome in this series were esotropia, Vpattern, abduction limitation, and compound hyperopic astigmatism. Intellectual assessment showed some degree of mental retardation in 75% of patients. Möbius' syndrome is associated with prenatal exposure to misoprostol.

Journal of Pediatric Ophthalmology and Strabismus 2001;38:156-162.
Retinal Detachment Associated With Subthreshold Retinopathy of Prematurity
Authors: Gurdian Silvio J , Gehlbach Peter L , MD Alex P , Robertson Joseph E
Published: April 2021

ABSTRACT

Purpose: To report a series of infants who progressed from mild retinopathy of prematurity (ROP) to severe ROP with retinal detachment without demonstrating detectable threshold disease.

Methods: Between January 1993 and August 1998, seven infants at Oregon Health Sciences University, followed in accordance with the Cryotherapy for Retinopathy of Prematurity Study (CRYO-ROP) protocol, progressed to retinal detachment despite documentation that threshold had not been reached. This outlying subset of patients was analyzed and compared to the cohort in the CRYO-ROP study.

Results: Six of 7 patients were male, 6 (86%) patients had symmetric disease, and all patients were born outside the study hospital. Mean birthweight was 877 g and mean gestational age was 26 weeks. Mean postconceptual age at the time of retinal detachment was 41 weeks. Because of bilateral detachment in 3 patients, the total number of study eyes is 10. Failure to achieve threshold resulted from insufficient clock hours or insufficient stage in 2 eyes and lack of plus in 8 eyes. Zone I disease was present in 1 eye.

Conclusion: Rarely, despite adhering to ROP examination protocol, the retina may detach without demonstrating antecedent threshold disease. Very low birthweight is a factor that may lead to a less predictable course. This study found a lack of plus disease results in failure to reach threshold more often than the occurrence of insufficient clock hours of stage 3 disease. Further study is needed to determine if selected cases of subthreshold ROP may benefit from ablative therapy.

Journal of Pediatric Ophthalmology and Strabismus 2001;38:279-283.
Morning Glory Disc Anomaly With Chiari Type I Malformation
Authors: Arlow Tim , Arepalli Sruthi , Flanders Adam E. , Shields Carol L.
Published: April 2021

Morning glory disc anomaly is a rare optic nerve dysplasia associated with various neovascular abnormalities. Due to these associations, children with morning glory disc anomaly have brain imaging and angiography to detect other congenital defects. The authors report the case of an infant with morning glory disc anomaly and coexisting Chiari type I malformation.
[J Pediatr Ophthalmol Strabismus 2014;51:e22–e23.]
Mini- and Maxi-peaks of Combined Hamartoma on Enhanced Depth Imaging Optical Coherence Tomography
Authors: Khoo Chloe T. L. , Magrath George , Shields Carol L.
Published: April 2021

A 17-year-old asymptomatic boy with a referral diagnosis of “macular gliosis” was found to have a combined hamartoma of the retina and retinal pigment epithelium. Enhanced depth imaging optical coherence tomography showed characteristic features of mini- and maxi-peaks from vitreoretinal traction.

[
J Pediatr Ophthalmol Strabismus.
2015;52:e38–e40.]
a collaborative model for university nursing education and agency staff development
Authors: Kornfeld-Jacobs Gila , Karshmer Judith F
Published: April 2021

ABSTRACT

A model is proposed for the integration of the education of senior nursing students and staff at a mental hospital, maximizing utilization of time and resources. A pilot study employed small group techniques with faculty as facilitators and resource persons, with the dual purpose of increasing competence and reducing communication barriers.

Four students and four nursing staff participated in weekly meetings, alternating supervision groups (2 groups, each composed of 1 faculty, 2 students and 2 staff) with discussion groups (2 faculty, 4 students and 4 staff),

Evaluation tools used did not yield significant differences between pre- and post-tests. However, objective and subjective indices point to positive changes of attitudes between all unit staff and students, improved therapeutic skills of students and staff, both on individual and group level.

Ongoing group meetings of patients run by students and staff resulted.
BIRTHDAYS
Authors: Greene Dayle , Barber Linda , Chorney Mona , Martyn Bonnie , Tanney Arlene , Thurston Norma , Tompkins Judith
Published: April 2021

A SPECIAL KINDOF ANNIVERSARY REACTION
Invitation to Compliance: The Prolixin Brunch
Authors: Cassino Terry , Spellman Nina , Heiman Julia , Shupe Jill , Sklebar H Thomas
Published: April 2021

Medication compliance is a critical factor in preventing decompensation ang promoting stabilty in the chronically mentally ill
"Overcoming Depression - Opening a Window to Recovery"
Authors: Anonymous
Published: April 2021

Mental Health Pamphlets Available
Sexplanation
Authors: Anonymous
Published: April 2021

Having "the talk" with your kids
THE NEGLECTED ELDER: A Family Systems Approach
Authors: Williams-Burgess Christine , Kimball Mary Jane
Published: April 2021

Abuse and neglect of older adults is largely an invisible problem. Those who are vulnerable are often hidden from the public eye. Troubled families characteristically maintain an isolated existence and, therefore, the mistreatment of elders can occur without the knowledge of neighbors or interested community members. Factors that operate to keep the problem hidden include society's emphasis on family privacy, the victim's unwillingness or inability to report the problem, stereotypes about the aged, and denial (Quinn, 1986). Although the problem of abuse and neglect of elders is not as prevalent as child maltreatment, it is a significant societal problem in need of increased public awareness. This article will focus on the treatment of elder neglect within the context of the family.
Adherence and Accuracy: SELF-MEDICATION DURING INPATIENT PSYCHIATRIC TREATMENT
Authors: Coudreaut-Quinn Eileen A , Emmons Mary Ann , McMorrow Martin J
Published: April 2021

Although medication continues to be the most widely used treatment for psychiatric symptomatology in most inpatient settings, many studies have documented the high incidence of nonadherence once patients leave the hospital.
A NURSE-LED EDUCATIONAL PROGRAM IN PSYCHIATRIC SETTINGS: Developing a Curriculum
Authors: Mohr Wanda K
Published: April 2021

The interactive nature of psychiatric mental health nursing provides an ideal environment for the teaching and role modeling of life skills to take place.
Healing the Mind-Body and Nursing Specialty Splits
Authors: Hoff Lee Ann , Edmands Margaret
Published: April 2021

Conference Regarding the "Blended" Role in Psychiatric/Mental Health Nursing

June 5, 1998 - University of Massachusetts, Lowell