bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple Role Women: The Real World of the Mature RN Learner
Authors: Green Clarissa P
Published: April 2021

ABSTRACT

The last quarter of this century is revealing exciting changes in university nursing education. With the endorsement of the BSN as entry to practice has come an unprecedented demand for university education for mature RN learners. Because of their personal, educational, and professional histories, their lack of familiarity with the university community, and their complex lives, these women present a unique challenge to university educators. Effective teaching of this large population of students is contingent upon educators' appreciation of them as mature female learners who lead busy lives and experience "academic shock" as part of their transition to becoming a baccalaureate graduate.
Choosing a Career: Why Not Nursing for More High School Seniors?
Authors: Stevens Karen A , Walker Eleanor A
Published: April 2021

ABSTRACT

Using a descriptive design, 641 college-bound high school seniors (CBHSS) in the Washington, DC, metropolitan area were surveyed to determine why nursing is not selected more frequently as a career. The findings indicated that the decision to choose or not choose nursing was significantly influenced by demographic characteristics (age, ethnicity, and race), past experiences with nurses/illness, and characteristics preferred in a future career. Those respondents who selected nursing cited wanting to help people, to do important work, and to work with a variety of people as important reasons for their choice. Those not choosing nursing indicated dislike of dying people and the salary as the main reasons for choosing another career.
Education of Nursing Students With Special Needs
Authors: Magilvy Joan K , Mitchell Andrea C
Published: April 2021

ABSTRACT

Recent legislation such as the Americans with Disabilities Act will have a significant impact on higher education in nursing. A survey was conducted to describe the extent to which BSN and ADN nursing programs in the United States admit and graduate special needs and chronically ill students, and to identify the accommodations which have been successful in providing nursing education to these students.

Responses received from 86 schools of nursing in 44 states indicated that most schools have had contact with students with special needs such as visual, hearing, or mobility impairments, learning disabilities, and mental or chronic illnesses. Learning disabilities and mental impairment were cited most frequently as having been present among the student population. Few programs have had experience with students with vision problems. While most programs responding had little experience with providing special accommodations to special needs students, most were aware of accessibility on their campuses.

Recent legislation aimed at creating opportunities for disabled individuals to successfully enter the work force creates challenges for schools of nursing in education of students with special needs. Issues are raised that must be addressed to meet this important challenge.
Factors Associated With Perceived Competency Levels of Graduating Seniors in a Baccalaureate Nursing Program
Authors: Mozingo Johnie , Thomas Sandra , Brooks Ellie
Published: April 2021

ABSTRACT

Factors hypothesized to affect perceived competency levels of graduating seniors were examined in three classes from a BSN program in a large southeastern university (N= 204). Although externship participation was unrelated to perceived competency, employment in a health care setting during the nursing program was positively related. Trait anxiety and social support were also significantly related to competency. A pervasive theme in both quantitative and qualitative data was students' desire for more practice of technical skills. Students also expressed the desire for more positive feedback from faculty. There are a number of implications of these findings, including curricular modifications, identification and intervention with highly anxious students, and increased faculty caring and support. Given the rigor of the professional nursing role, we owe it to our graduates to send them into the work arena with a healthy sense of self-confidence.
Knowledge-Driven Problem-Solving Models in Nursing Education
Authors: Cholowski Krystyna M , Chan Lorna K S
Published: April 2021

ABSTRACT

This paper compares the hypothetico-deductive model of clinical problem solving commonly used in current nurse education and practice with the knowledge-driven problemsolving model (Bordage, Grant, & Marsden, 1990). It is argued that the knowledge-driven model provides a more complete account of the processes involved in clinical problem solving. The knowledge-driven model emphasizes the organization and availability of relevant content knowledge stored in memory as the prime determinant of clinical problem solving. This contention is discussed in relation to the development of a clinical problem-solving task for nursing students and its implications for nursing curricula.
Fostering Dialogical Community Through a Learning Experience
Authors: Porter Eileen Jones
Published: April 2021

ABSTRACT

Dialogue and community are two common foci of the recent nursing education literature. The author came to a new understanding of these concepts while teaching a capstone seminar course for registered nurses who were obtaining a baccalaureate degree. In this paper, this transformation is discussed in the context of one particular learning experience for the capstone course. The philosophical basis for fostering dialogical community through this learning experience is explained. The experience is described, and students' comments about the experience are cited. Finally, conclusions drawn as a result of the experience are compared to the themes of dialogue and community in the recent nursing education literature.
A Research Development Program for Minority Honors Students
Authors: Inouye Jillian
Published: April 2021

ABSTRACT

This article describes an experiential undergraduate honors research program for minority students. Through a participatory and mentoring process students are able to complete a research project, present it at a national colloquium, and prepare it for publication in a 2-year program. A review of the literature on different methods to teach research was presented. The outcome of the project suggests the model was highly successful in achieving its goals.
Evaluation of the Facts on Aging Quizzes I & II
Authors: Lusk Sally L , Williams Reg A , Hsuing Stella
Published: April 2021

ABSTRACT

The Facts on Aging Quizzes (FAQ) I and II (Palmore, 1977, 1981) were designed to assess knowledge and to measure misconceptions regarding the elderly. This study compared results on the FAQ I and II administered to freshmen nursing students. In contrast with Palmore's (1981, 1988) findings, the FAQ I and II were not related (r=.04) and alpha coefficients were low (a=.45 and .32 respectively). However, use of theta coefficients (which make fewer stringent assumptions about items being parallel) resulted in values of .60 and .64 respectively. The factors emerging in this study differed from Palmore's (1977, 1981, 1988) conceptual structure and Norris, Tindale, and Matthew's (1987) factor structure and explained only 45% of the variance. Results from this study suggest that while the FAQ I and II may be useful as a stimulus for discussion, revisions and testing need to be done if they are to be used for research purposes.
Evaluating Teaching Effectiveness
Authors: Kirschling Jane Marie , Fields Jonathan , Imle Margaret , Mowery Melinda , Tanner Christine A , Perrin Nancy , Stewart Barbara J
Published: April 2021

ABSTRACT

Major reform in nursing education is underway, with increased emphasis being placed on the importance of the teacher-student relationship. An instrument for evaluation of teaching effectiveness, developed at the Oregon Health Sciences University School of Nursing, attempts to capture the student's perception of the quality of the teacher-student relationship as well as other salient aspects of teaching practices. The evaluation tool contains 26 items evaluating teaching effectiveness and 14 items that evaluate the course. The teaching effectiveness items yield five scales including: knowledge and expertise, facultative teaching methods, communication style, use of own experiences, and feedback. Psychometric testing has been completed and there is evidence of construct validity in relation to teaching effectiveness and internal consistency reliability for the five scales.
Characteristics of Graduate Adult Health Nursing Programs
Authors: Stokes Elizabeth , Whitis Grace , Moore-Thrasher Lavanda
Published: April 2021

ABSTRACT

This descriptive study explored the current characteristics and emphases of graduate programs which offer adult health nursing curricula. All NLN-accredited master's programs offering the adult health focus were requested to send selected demographic information and materials/bulletins normally sent to prospective students. The Conrad and Pratt model for curriculum decisionmaking was used to organize results related to environmental input and curriculum design variables. Descriptive statistics were employed to analyze admission requirements, types of study permitted, length of program, type of courses (core, electives/cognates, specialty) and completion requirements.

Results indicated that adult health graduate programs have multi-tracks. Students were generally attending part-time. Full-time study completion time was four to six semesters. Evening and one day per week offerings were frequently found, as were numerous innovative strategies. Prevalent admission requirements were: graduation from an NLN-accredited BSN program, current licensure, specified GPA, GRE scores, health assessment and statistics courses, professional references and possible personal interview. Most programs required core courses in theory/conceptual frameworks, issues, roles, statistics and research. Electives/cognate courses and thesis/non-thesis options were present in most programs.
An Honors Program: Directing Our Future Leaders
Authors: Hartshorn Jeanette C , Berbiglia Violeta A , Heye Mary
Published: April 2021

ABSTRACT

Development of future leaders is a priority of nurse educators. In this article an honors program, which was initiated to prepare students who would contribute to nursing science and become effective leaders, is described. The process used to gain faculty and administrative support is highlighted. The discussion also includes specifics regarding recruitment and selection of students and sequencing of courses. Evaluation of the program suggests that graduates assume leadership positions within the profession. Honors programs such as this one help to prepare leaders and scholars for tomorrow.
The Development of Students' Perceptions of Effective Teaching: The Ideal, Best and Poorest Clinical Teacher in Nursing
Authors: Benor Dan E , Leviyof Iris
Published: April 2021

ABSTRACT

This article attempts to study students' perceptions of effective clinical teacher in nursing. To do this, 123 students from three schools with different curricula identified the important characteristics of a clinical teacher, using a modified NCTEI instrument. Then each respondent assessed to what extent her or his best and poorest clinical teachers possess these characteristics. The profile of an effective clinical teacher which emerged places the highest weight on the nursing competencies of the teacher and downplays both interpersonal relationships and personality traits. Differences between 2nd and 3rd year students were found in the placement of teaching skills and evaluation characteristics. No differences were disclosed among the compared schools. Conflicting research findings are analyzed. The results strongly suggest that the image of the ideal clinical teacher is not rooted in an existing teacher figure. The possible implications of the findings on the role model function of the clinical teacher are discussed.
Returning to School to a Baccalaureate Program: Is There an Easy Way to Learn?
Authors: Duff Viola M
Published: April 2021

ABSTRACT

Registered nurses returning to school need to learn many new skills in their first courses at the university. The assignment presented here assisted students in learning the course content and honing other skills needed for their academic life. Design and implementation of the assignment as well as comments and recommendations for change will be given.
Preventing Nursing Student Exposure Incidents: The Role of Personal Protective Equipment and Safety Engineered Devices
Authors: Schaffer Susan
Published: April 2021

ABSTRACT

This descriptive study used a self-selected sample of 580 newly licensed Virginia registered nurses to examine risk factors for percutaneous (needlestick) and mucocutaneous (splash) exposure incidents to blood or body fluids that occurred while they were nursing students. Fifty-one exposure incidents were reported by 42 respondents (7% of total). Twenty of 31 percutaneous exposure incidents were potentially preventable through the use of safety-engineered devices. Similarly, 4 of 10 mucocutaneous incidents occurring during routine procedures were potentially preventable through the use of personal protective equipment. Limited use of safetyengineered devices and personal protective equipment in the occurrence of nursing student exposure incidents suggests that active steps by schools of nursing to ensure student access to and use of personal protective equipment and safety-engineered devices may minimize exposure incident risk for students.
Responses of Baccalaureate and Graduate Programs to the Emergence of Choice in Nursing Accreditation
Authors: Bellack Janis P , Gelmon Sherril B , O'Neil Edward H , Thomsen Catherine L
Published: April 2021

ABSTRACT

Specialized accreditation in nursing is a widely recognized and respected hallmark of program quality. The advent of a second specialized accrediting agency for baccalaureate and higher degree programs in nursing prompted a survey of these programs to determine their choice of nursing accreditation agency, factors influencing their choice, their perceptions of the value added by nursing accreditation, and the difficulties encountered with the accreditation process. These study variables and the relationships between choice of accrediting agency and types of degree-granting nursing education programs offered by the institution, agency membership in the National League of Nursing (NLN) or the American Association of Colleges of Nursing (AACN), expected date of next accreditation vieit, geographic region, public versus private status, and type of institution (Carnegie classification) were analyzed. Findings revealed that nearly a quarter (24%) of respondents intend to continue with the NLN Accrediting Commission (NLNAC), whereas 30% indicated they have already switched to the Commission on Collegiate Nursing Education (CCNE) or intend to do so prior to their next accreditation cycle. However, nearly a quarter (24%) of respondents said they plan to be accredited by both agencies for the immediate future, and 21% indicated they are still undecided. Study findings suggest an end to single-source accreditation, and the beginning of a new market-oriented approach.
Content Validity Exercises for Nursing Students
Authors: Beck Cheryl Tatano
Published: April 2021

ABSTRACT

In instrument development, the assessment of content validity is a critical step. However, content validation often is given superficial and cursory attention. Because the procedure involved in assessing content validity is not addressed in depth in research textbooks, nursing students may not fully understand or appreciate the intricacies required in this crucial process. The purpose of thia article ia to share some content validity exercises the author has developed for use with both undergraduate and graduate nursing students. These exercises involve an instrument, entitled the Postpartum Depression Screening Scale, which the author is currently developing.
Jumping Through Hoops, Walking on Egg Shells: The Experiences of Nursing Students With Disabilities
Authors: Maheady Donna Carol
Published: April 2021

ABSTRACT

This study describes the experiences of nursing students with disabilities through interviews, observations, and document analysis. The sample included 10 current students and graduate nurses with physical or auditory impairments and 61 nursing faculty members, staff members, patients, and fellow students. The Colaizzi method of data analysis was modified to include additional information from interviews, observations, and documents. The findings reveal important concerns related to potentially unsafe nursing practices. The findings should assist nursing faculty with admission and retention decisions and development of reasonable accommodations. Recommendations for nursing programs to develop enforceable guidelines for admission are included.
Faculty and Student Cross-Cultural Learning Through Teaching Health Promotion in the Community
Authors: Moch Susan Diemert , Long Geraldine L , Jones Josette Wouters , Shadick Kathleen , Solheim Karen
Published: April 2021

ABSTRACT

Cross-cultural learning for nursing students and faculty increased through a collaborative venture of teaching health promotion classes in a Hmong community. Through the learning process, nursing students and faculty learned about Hmong culture, and Hmong participante learned about health. The purpose of this article is to describe the process and evaluation of health promotion classes in a Hmong community.
Baccalaureate Nursing Faculty Performance of Nursing Computer Literacy Skills and Curriculum Integration of These Skills Through Teaching Practice
Authors: Austin Sandra I
Published: April 2021

ABSTRACT

This article describes a cross-sectional survey research study designed to collect data from nurse educators regarding their self-reported competence in the performance of 60 nursing computer literacy skills, as well as self-reported levels of integration of these skills, through teaching practice, into the curricula of their respective baccalaureate nursing programs. Data were received from 184 respondents representing 18 publicly funded, National League for Nursing-accredited, college and university generic baccalaureate degree programs in the New England region of the United States. Study findings revealed that 21 of the 60 skills were being performed "well" or "very well" as reported by 50% or more of respondents, while in the area of curriculum integration through teaching practice, only 3 of the 60 skills were being integrated into teaching practice either "moderately" or "extensively" as reported by 50% or more of respondents. Another major finding of this research study strongly suggested that faculty who have the ability to perform requisite nursing computer literacy skills comfortably are more likely to integrate these skills into the curriculum through their teaching practices (r = .76; p < .01). This article concludes with a discussion of the implications of the study findings for nursing education.
Beyond Correspondence, Video Conferencing, and Voice Mail: Internet-Based Master's Degree Courses in Nursing
Authors: Wambach Karen , Boyle Diane , Hagemaster Julia , Teel Cynthia , Langner Barbara , Fazzone Patricia , Connors Helen , Smith Carol , Forbes Sarah
Published: April 2021

ABSTRACT

The changing health care system and increasing demands for primary care providers have prompted an increase in nurse practitioner programs in the United States. Nurses in rural areas that are underserved by primary care practitioners often are faced with time and distance barriers to returning to school for advanced education. This article describes Internet-based courses as a unique distance learning platform for preparing primary care nurse practitioners at the University of Kansas (KU) School of Nursing. Discussion includes course development process, matching methods to course content, and other information on promoting interaction between students and faculty.
The Effects of Computer-Assisted Instruction on the Self-Efficacy of Baccalaureate Nursing Students
Authors: Madorin Sandra , Iwasiw Carroll
Published: April 2021

ABSTRACT

As computer-assisted instruction (CAI) use has increased during the past few years, nurse educators have expressed concern regarding its effectiveness. The purpose of this quasiexperimental study was to determine if completion of a computerized simulation about a surgical patient increased baccalaureate nursing students' self-efficacy about caring for surgical patients in the clinical environment. Such an association is desirable because increased levels of self-efficacy have been associated with increased motivation, goal-setting, and achievement. A nonprobability, convenience sample (N = 23) of second-year baccalaureate nursing students was assigned randomly to experimental and control groups. The self-efficacy of the experimental group was measured three times: on an initial pretest; following the intervention of a computer simulation; and after an 8-week clinical rotation. The self-efficacy of the control group was measured on an initial pretest and after the 8-week rotation. Higher preclinical self-efficacy scores (p < .01) of the experimental group support the use of CAI as an important aspect of clinical education. Implications for nursing education, practice, and research are addressed.
Entry-Level Competencies Needed by BSNs in Acute Health Care Agencies in Tennessee in the Next 10 Years
Authors: King Marjorie S , Smith Patricia L , Glenn L Lee
Published: April 2021

ABSTRACT

This study focused on the identification of entry-level competencies needed by bachelor of science in nursing (BSN) graduates who will begin working in acute health care agencies in Tennessee within 10 years. The purpose of this study was to increase awareness of the competencies needed by graduates of BSN programs in Tennessee to meet the demands of acute health care agencies, considering current and anticipated changes in the health care delivery system. The opinions of nurse educators, nurse administrators, recent BSN graduates, and experienced BSN graduates were solicited to assess congruency of perceptions. This study found there was a statistically significant difference in the perceptions of nurses in acute health care agencies and faculty in BSN programs about the importance of entry-level competencies needed by BSN graduates.
New Approach for Teaching Health Promotion in the Community: Integration of Three Nursing Courses
Authors: Moshe-Eilon Yael , Shemy Galia
Published: April 2021

ABSTRACT

The complexity of the health care system and its interdisciplinary nature require that each component of the system redefine its professional framework, relative advantage, and unique contribution as an independent discipline. In choosing the most efficient and cost-effective workforce, each profession in the health care system must clarify its importance and contribution, otherwise functions will overlap and financial resources will be wasted. As rapid and wide-ranging changes occur in the health care system, the nursing profession must display a new and comprehensive vision that projects its values, beliefs, and relationships with and commitment to both patients and coworkers. The plans to fulfill this vision must be described clearly.

This article presents part of a new professional paradigm developed by the nursing department of the University of Haifa, Israel. Three main topics are addressed:

* The building blocks of the new vision (i.e., community and health promotion, managerial skills, academic research).

* Integration of the building blocks into the 4-year baccalaureate degree program (i.e., how to practice health promotion with students in the community setting; managerial nursing skills at the baccalaureate level, including which to choose and to what depth and how to teach them; and academic nursing research, including the best way to teach basic research skills and implement them via a community project).

* Two senior student projects, demonstrating practical linking of the building blocks.
Diffuse Infiltrating Retinoblastoma Associated With Persistent Primary Vitreous
Authors: Liang James C , Augsburger James J , Shields Jerry A
Published: April 2021

ABSTRACT

A two-and-a-half-year-old male child presented with unilateral leukocoria. Clinical examination disclosed what was believed to be a mild form of persistent hyperplastic vitreous associated with total retinal detachment and exophytic retinoblastoma. The enucleated eye contained diffuse infiltrating retinoblastoma with tumor cells involving a stalk of persistent primary vitreous without hyperplasia.
Medical Management of Congenital Nasolacrimal Duct Obstruction
Authors: Paul T Otis
Published: April 2021

ABSTRACT

Fifty-five infants were diagnosed to have nasolacrimal duct obstruction by an ophthalmologist prior to three months of age. All were followed prospectively, primarily with medical management. Seven were treated surgically. In the 55 infants, there were 62 obstructed nasolacrimal ducts. Eighty-nine percent (55/62) of the nasolacrimal ducts were opened with medical management only in the first sixteen months of life. Of the nasolacrimal ducts that opened spontaneously, 15% (8/55) were open at three months, 45% (25/55) were open at six months, 71% (39/55) were open at nine months, and 93% (51/55) were open at one year. Based on this data one can advise the parents of infants with nasolacrimal duction what the odds of remission are without surgery by the twelfth month of age. Of the infants obstructed at three months of age, 80% were clear by the twelfth month. Of the infants obstructed at six months, 70% were clear by the twelfth month and of those still obstructed at nine months, 52% were clear by the twelfth month.
Hard Contact Lenses in the Management of Congenital Cataracts
Authors: Pratt-Johnson J A , Tillson G
Published: April 2021

Abstract

This paper describes our experience with 54 eyes which were optically corrected with polymethylmethacrylate hard contact lenses following the removal, in infancy, of a congenital cataract. The lenses were tolerated well, few alterations were required and the majority of patients did not lose more than one lens a year. Our results show that it is possible to obtain visual acuity of 20/25, in unilateral congenital cataract cases.
Acquired Retraction Syndrome Associated With Orbital Metastasis
Authors: Kivlin Jane D , Lundergan Maureen K
Published: April 2021

ABSTRACT

A patient with metastatic disease of the lateral orbit developed an acquired motility defect similar to Duane's retraction syndrome. An acquired retraction syndrome, unlike the congenital form, is due either to mechanical defects of the orbit and eye or to neurologic disease. The direction of gaze in which the retraction occurs is the clinical clue to the location of the restricting element in the mechanically caused cases.
Congenital Unilateral Orbital Fibrosis With Suspected Prenatal Orbital Penetration
Authors: Effron Lorri , Price Ronald L , Berlin A Jan
Published: April 2021

ABSTRACT

Congenital fibrosis of the extraocular muscles includes various abnormalities ranging from isolated fibrosis of a single muscle to bilateral involvement of all extraocular muscles. Congenital unilateral orbital fibrosis is a specific fibrosis syndrome with only five cases previously reported. Although these reports postulated that a prenatal orbital inflammatory process caused the fibrosis, no etiology was proposed, nor was a mechanism suggested for entrance of the inflammation into the orbit.

We discuss three additional cases in which evidence suggested prenatal orbital penetration. In one, a dense scar was found at birth from the skin of the upper lid to beyond the trochlea. The second had a dense fibrous tract extending from the upper lid skin to the trochlea and beyond into the orbit without a skin scar. These lesions could have been inflicted by the fetuses' own fingers or toes or, in the second case, by the twin fetus. The third had a benign mesenchymoma of the nasopharynx and skull that had eroded the medial orbital wall, which was seen on computed tomography scan but not on routine x-rays.

The nature of the inflammatory substance is unknown. There was no other evidence of inflammation or infection in the eight reported cases. Possibly amniotic fluid itself, entering the orbit "late" in gestation, might cause this inflammation.

We recommend that all children with congenital unilateral orbital fibrosis be examined specifically for defects in the orbit, and that computed tomography be employed rather than plain x-rays.
Unilateral Traumatic Aphakia in Children: Role of Corneal Contact Lenses
Authors: Jain I S , Mohan Kanwar , Gupta Amod
Published: April 2021

ABSTRACT

Twenty-eight children below ten years of age with unilateral traumatic aphakia were fitted with hard corneal contact lenses. Visual acuity of 6/12 or better was achieved in 68% of the cases. Patients who were above seven years of age at the time of injury, and those fitted with contact lenses within eight months of trauma, were found to have better chances of recovering normal binocular functions.
Ocular Perforation and Phthisis Bulbi Secondary to Strabismus Surgery
Authors: Apple David J , Jones Gary R , Reidy James J , Loftfield Katherine
Published: April 2021

ABSTRACT

We present our ocular clinicopathologic findings of a child who suffered bilateral perforation of the globe during medial rectus recession bilaterally for congenital esotropia. The right eye progressed to a painful phthisis bulbi and subsequently required enucleation. Penetration or perforation of the sclera during extraocular muscle surgery is not rare; however, serious sequelae such as visual loss or loss of the eye are unusual. Such complications can be avoided if the surgeon is aware of the causes, as well as the dangers, of such perforation, and, in particular, if modern spatula-type needles are used.
Studies of Strabismus and Amblyopia in Infant Monkeys
Authors: Boothe Ronald G , Kiorpes Lynne , Carlson Melvin R
Published: April 2021

ABSTRACT

Longitudinal studies of grating acuity have been conducted with strabismic infant monkeys. Representative data from several different monkey models of strabismus are presented. Acuity in the fixating eyes of these monkeys developed to adult levels similarly to acuity development in normal infant monkeys. Acuity in the non-fixating eyes often lagged behind, and in some cases never reached normal levels, resulting in a permanent amblyopia.
Retinoblastoma: Survival, Age at Detection and Comparison 1914-1958, 1958-1983
Authors: Abramson David H , Ellsworth Robert M , Grumbach Nicholas , Kitchin F David
Published: April 2021

ABSTRACT

A retrospective analysis of the records of 1531 retinoblastoma patients (809 male, 720 female, sex of two not known) was carried out to ascertain life table survivals. Of patients seen between 1914 and 1983 survival from metastatic retinoblastoma was the same for unilateral and bilateral patients. Metastatic retinoblastoma occurred within four years from diagnosis of the unilaterally affected patients and within nine years from diagnosis of the bilaterally affected patients. Survival thereafter remained at 76%. Because of the development of second non-ocular tumors in survivors of bilateral retinoblastoma there was a dramatic difference between survival of the patient with unilateral and bilateral disease. Within five years after diagnosis of bilateral retinoblastoma more children die from their second tumor than retinoblastoma itself. By 25 years after diagnosis more than 50% of the bilaterally affected children are dead and by 35 year?, 59% are dead.

There was no difference between survival of boys and girls. Although bilateral patients were seen at significantly lower ages at diagnosis, they did not have a lower mortality rate from metastatic retinoblastoma. Despite the fact that bilaterally affected children with a family history were diagnosed at a younger age than those without a family history (11 vs. 15 mos.) mortality from metastatic retinoblastoma was the same. Similarly, even though unilateral patients with a family history were diagnosed younger than those without a family history (5 vs. 25 mos.) mortality from metastatic retinoblastoma was the same. There has been little change in the age at detection for retinoblastoma in the pre- versus post-1958 series and no change in survival rate for bilateral or unilateral patients. We propose that there may be a "biological window," i.e., a range of ages where lowering the age of detection is not associated with a lowering of survival and that this window extends from the first few months of life into the second year of life.
Congenital Nystagmus in Identical Twins: Discordant Features
Authors: Spooner Sharon Nau , Bateman J Bronwyn , Yee Robert D
Published: April 2021

ABSTRACT

Identical twins with congenital nystagmus were examined and studied with eye movement recordings and videotaping. The nystagmus differed in its location of the null zone, its frequency and amplitude, the degree of persistence in the dark, and the degree of impairment of pursuit and optokinetic nystagmus. As the two boys have the identical genetic constitution, we postulate that the discordant features of the nystagmus represent variable expressivity or, alternatively, the influence of environmental factors.
Periocular Congenital Melanocytic Nevi
Authors: Margo Curtis E , Rabinowicz I Matthew , Habal Mutaz B
Published: April 2021

ABSTRACT

Large congenital melanocytic nevi (CMN) are cutaneous malformations of neural crest origin that have a notorious reputation because of their reported propensity to undergo malignant degeneration. Traditionally, complete surgical excision has been advocated based on the premise that large CMN are a precursor to melanoma. Two cases of large periocular CMN are reported to emphasize the importance of distinguishing them from other congenital skin lesions. Data from the literature support the contention that these pigmented skin lesions spawn malignancies and that prophylactic therapy may be indicated.
Clinical Assessment of Visual Function in the Young Child: A Prospective Study of Binocular Vision
Authors: Rogers G L , Bremer D L , Leguire L E , Fellows R R
Published: April 2021

ABSTRACT

Binocular vision was evaluated in 12 children with infantile esotropia before and after corrective surgery. Stereopsis was measured by the eye movement/global stereopsis method. Also in a subgroup of four infants, binocular and monocular pattern VERs were recorded to evaluate binocular summation. Results revealed 50% of the infantile esotropia children who had corrective surgery before one year of life developed gross stereopsis two weeks following surgery. In addition, of four infants who showed no evidence of stereopsis, 50% showed some degree of binocular summation following surgery. The importance of prospective studies of binocular vision in infantile esotropia is discussed within the context of new tests that can be used to objectively assess binocularity in the preverbal child.
Preferential Looking as a Guide for Amblyopia Therapy in Monocular Infantile Cataracts
Authors: Catalano Robert A , Simon John W , Jenkins Paul L , Kandel Gillray L
Published: April 2021

ABSTRACT

Despite recent advances in surgical technique and refractive correction, amblyopia remains a significant problem in the treatment of monocular infantile cataracts. Amblyopia therapy recommended by different authors during the preverbal period has varied from no patching to nearly full-time occlusion of the phakic eye.

We measured preferential looking (PL) acuities sequentially in four infants following monocular cataract surgery and contact lens correction. This information was used to adjust occlusion of the phakic eye, which was prescribed 25%-100% of waking hours. Patching schedules were altered, on average, every three to four months in response to changes in PL acuities. Four increases in patching intensity retarded acuity development in the phakic and benefited development in the aphakic eyes. Nine decreases enhanced progress or yielded no change in the phakic and, with two exceptions, impeded progress in the aphakic eyes. Recognition acuities now available for two of the children show continuity with previous PL acuities and confirm useful vision in the aphakic eyes.

We describe guidelines for adjusting occlusion based on our experience. We believe that PL modulation of patching therapy may result in more favorable visual outcomes for both eyes of infants with monocular cataracts.
Collagen Maturation Defects in Ehlers-Danlos Keratopathy
Authors: May Maureen A , Beauchamp George R
Published: April 2021

ABSTRACT

Ehlers-Danlos syndrome is one of many inherited abnormalities of connective tissue, specifically collagen. A 16year-old Caucasian female with Type VI Ehlers-Danlos syndrome had five unusual corneal findings, four of which have not been reported in association with Ehlers-Danlos syndrome: micro-cornea (previously reported), cornea plana, keratoconus posticus, stromal haze at the level of Bowman's layer and a peripheral ring opacity suggestive of anterior embryotoxon. Type VI Ehlers-Danlos syndrome is associated with deficient activity of lysyl hydroxylase which ultimately is responsible for cross-Unking collagen chains, the source of its tensile strength. Genetic regulation of procollagen formation is believed to be mediated by mRNA. Aggregation and maturation in the extracellular matrix is probably influenced and mediated by its evolving biochemical environment, particularly by complex carbohydrate moieties. An understanding of collagen maturation, and the pathophysiologic and biophysical consequences of abnormalities at this level of biochemical organization, permits more specific understanding of ocular dysmorphology and collagen diseases.
Detection of Amblyopia With P-VEP During Chloral Hydrate Sedation
Authors: Wright Kenneth W , Eriksen K Jeffrey , Shors Tracey J
Published: April 2021

ABSTRACT

A major limitation of methods presently used for detecting amblyopia in preverbal children and infants is their dependence on patient cooperation. In response to this problem, we have introduced the use of chloral hydrate sedation as a means of obtaining the pattern visual evoked potential (P-VEP) in uncooperative infants. Twenty-five infants were studied: 14 with clinically diagnosed amblyopia, four with questionable amblyopia, and seven with no clinical sign of amblyopia. In patients with known amblyopia, P-I amplitudes from the amblyopic eye were greatly diminished when compared with responses obtained from the non-amblyopic fellow eye, with amplitude ratios ranging from 0 to 0.66 (mean 0.36). In contrast, P-I responses from non-amblyopic infants were quite symmetrical, with amplitude ratios of 0.82 to 0.98 (mean 0.92). These results indicate that the P-VEP can be obtained during chloral hydrate sedation and that P-1 responses reflect the presence or absence of amblyopia. Performing P-VEP during chloral hydrate sedation thus holds promise as an important clinical tool for the diagnosis of amblyopia in uncooperative infants and children.
The Rieger Syndrome and a Chromosome 13 Deletion
Authors: Stathacopoulos Rena A , Bateman J Bronwyn , Sparkes Robert S , Hepler Robert S
Published: April 2021

ABSTRACT

The Rieger syndrome, characterized by a prominent Schwalbe line, iris strands to the cornea, iris hypoplasia, dental abnormalities, facial malformations, and umbilical defects, is inherited in an autosomal dominant pattern. We studied a boy with the ocular features of the Rieger syndrome, micrognathia, and redundancy of the periumbilical skin. Chromosome analysis revealed an interstitial deletion of the long arm of chromosome 13 involving the distal region of band ql4 through band q31. As there was a previous report of the Rieger syndrome in a child with an interstitial deletion of chromosome 13(ql2,q22), we suggest that a gene for this disorder may be located in the segment ql4 to q22.
Long-Term Strabismus Complications Following Retinal Detachment Surgery
Authors: Muñoz Michelle , Rosenbaum Arthur L
Published: April 2021

ABSTRACT

Thirty-three consecutive patients with persistent strabismus following retinal detachment surgery were studied retrospectively. A large number of vertical and torsional problems were seen. Various restrictive abnormalities were identified during strabismus surgery. These included superior oblique tendon displacement anteriorly, leash and reverse leash types of restrictions, myoscleral adhesions posterior to the exoplants, and stretching of the muscles induced by large underlying exoplants. The results following strabismus surgery were analyzed. Eighty percent of the patients were able to achieve single binocular vision in the primary field of gaze, with a low incidence of complications. The adjustable suture procedure was thought to be helpful.
Simultaneous Surgery for Bilateral Congenital Cataracts
Authors: Guo Suqin , Nelson Leonard B , Calhoun Joseph , Levin Alex
Published: April 2021

ABSTRACT

In about one third of patients congenital cataracts are bilateral. If the cataracts are dense, and the patient an infant, bilateral simultaneous cataract removal reduces anesthetic risk, hospital stay, and cost and allows earlier optical correction. This study represents a retrospective survey of 32 eyes (16 cases) with simultaneous surgery for bilateral congenital cataracts. Bilateral simultaneous surgery can be performed to avoid a second general anesthesia in infants who have bilateral dense congenital cataracts.
Subperiosteal Orbital Masses in Children With Orbital Cellulitis: Time for a Reevaluation?
Authors: Catalano Robert A , Smoot Catherine N
Published: April 2021

ABSTRACT

Conflicting reports have arisen in the literature regarding the diagnostic criteria and management of children with a suspected subperiosteal orbital abscess (SOA). To highlight the dilemmas that have arisen a child with a posterior subperiosteal mass, as demonstrated by computerized tomography, is presented. This case and others in the literature suggests a need for better radiographic criteria for distinguishing an SOA from reactive inflammatory edema. Until such criteria are developed, the management of suspected SOA in children should be based principally on clinical signs. Radiographic examinations should be used primarily to rule out the need for surgical intervention.
Dominant Macular Colobomata
Authors: Satorre Jorge , Lopez José M , Martinez Juan , Piñera Pedro
Published: April 2021

ABSTRACT

Hereditary bilateral macular colobomata are not a consequence of an anomalous closure of the fetal fissure. Their extreme rarity, their lack of embryological explanation, and their morphologic similarity to postinflammatory congenital macular scars called the hereditary-malformative etiology of this entity in question. The authors describe a four generation family with seven affected members with isolated autosomal dominant bilateral macular colobomata.
Photophobia, Epiphora, and Torticollis: A Masquerade Syndrome
Authors: Marmor Maury A , Beauchamp George R , Maddox S Fleetwood
Published: April 2021

ABSTRACT

Three young children presented with photophobia, epiphora, and torticollis as the initial manifestation of a posterior fossa tumor. In each case there was a delay in treatment due to the presumptive diagnosis of a local ocular inflammatory condition. We recommend that children with unexplained photophobia, epiphora, and torticollis undergo an imaging technique to evaluate the posterior fossa.
The Surgical Overcorrection of Intermittent Exotropia
Authors: Keech Ronald V , Stewart Susan A
Published: April 2021

ABSTRACT

Many strabismus surgeons recommend an initial surgical overcorrection for intermittent exotropia. Others caution against overcorrection because of possible nasal suppression and amblyopia in children, or because of possible diplopia in adults. We reviewed the records of 69 patients who were initially overcorrected following surgery for an intermittent exotropia. The mean postoperative follow-up was 3.1 years. Eight patients (11.6%) had a persistent overcorrection of 3 prism diopters or more and three patients (4.3%) had persistent diplopia. Patients with a persistent overcorrection had a greater mean age (P < .02) and a greater mean initial overcorrection (P < .005) compared with the patients who were not overcorrected 3 Δ or more. No child lost stereoacuity or developed amblyopia due to the overcorrection.
Bilateral Consecutive Superior Oblique Palsy Following Fronto-Ethmoidal Sinusitis
Authors: Lyons C J , Lee J P
Published: April 2021

ABSTRACT

A 61-year-old woman developed a left superior oblique palsy as a result of frontoethmoidal sinusitis. After stabilization, the left inferior oblique and right inferior rectus were recessed. Three years later, she developed a right superior oblique palsy associated with frontoethmoiditis. The right inferior oblique and left inferior rectus were recessed.
A Unique Epibulbar Osseous Choristoma
Authors: Melki Toufic S , Zimmerman Lorenz E , Chavis Richard M , Ellsworth Randy , O'Neill John F
Published: April 2021

ABSTRACT

The case of a 14-year-old girl found to have a unique epibulbar osseous choristoma attached to the sheath of the superior rectus muscle is recorded. The bony mass was palpable through the upper lid and by computerized tomography, it appeared densely calcified and noncystic. There was no ptosis or abnormality in ocular motility preoperatively or postoperatively.
The Site of Reattachment of the Extraocular Muscle Following Hang-Back Recession
Authors: Repka Michael X , Fishman Peggy J , Guyton David L
Published: April 2021

ABSTRACT

The use of "hang-back" suspensions has been shown to be an effective means of weakening rectus muscles. The exact position where the muscle reattaches to the globe has, however, been questioned. We performed eight large hang-back recessions on the rectus muscles of cynomolgus monkeys. Eight weeks postoperatively the attachment sites were determined by reexploration. Six of the recessions were within 0.5 mm of the intended site. The muscles were found an average of 0.4 mm anterior to the intended position. These results confirm that the muscle reattaches close to the intended location. Eight exaggerated recessions were similarly performed; these were more variable in the site of reattachment. Only three muscles were reattached within 0.5 mm of the intended site. There was a mean forward reattachment of 1.1 mm. Four of the 16 muscles were found reattached by a pseudotendon rather than directly to the sclera.
Late Ophthalmic Manifestations of the Shaken Baby Syndrome
Authors: Han Dennis P , Wilkinson W Scott
Published: April 2021

ABSTRACT

We examined six children between 12 and 55 months after an initial shaking injury to determine whether visually significant retinal abnormalities persisted, despite clearing of intraocular hemorrhage. In two children (age 21 months and 6.7 years at follow-up), visual acuity was reduced due to macular folds occurring in the region of previous large subhyaloid hemorrhages. A third child (age 3.2 years) had a midperipheral lacunar defect of the retinal pigment epithelium which was not visually significant. Cerebral injury was responsible for an apparent profound visual loss in three children. Our findings indicate that both macular folds and cortical injury are functionally significant complications of the shaken baby syndrome.
Congenital Glaucoma and Skeletal Dysplasia
Authors: Mawn Louise A , O'Brien Jane E , Hedges Thomas R
Published: April 2021

ABSTRACT

We have observed congenital glaucoma in a patient with a skeletal dysplasia closely resembling Kniest syndrome. The clinical and radiographic features, along with the differential diagnosis of Kniest syndrome, are discussed. Review of the literature suggests a relationship between the pathophysiology of bone dysplasia and congenital glaucoma. Congenital glaucoma may be an additional ocular finding in Kniest syndrome.