bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between Graduate Preparation and Clinical Teaching in Nursing
Authors: Herrmann Marilyn M
Published: April 2021

ABSTRACT

In recent years, there has been a shift in graduate education from preparing teachers of nursing to preparing advanced clinicians. Whether this shift has made a difference in the clinical teaching skills of the nurse educator has not been addressed. The purpose of this study was to survey clinical teachers in nursing schools and examine whether or not courses in educational theory had any relationship to the "effectiveness" or "time spent" in using various teaching techniques in the clinical setting. This nonexperimental survey research used a convenience sample (692) drawn from all National League for Nursing-accredited baccalaureate schools. Only three small significant differences were found, using the t-test, for effectiveness and time spent in teaching strategies between faculty with educational preparation when compared to those without. Although results of this study failed to show significant differences in teaching techniques based on educational preparation, they did indicate a need for educational content to prepare for the teaching role. Discussion of preparation for the teaching role is included.
Young People Considering Nursing as a Career: Starters vs. Non-starters
Authors: Ehrenfeld Mally , Rotenberg Aviva , Sharon Rina , Bergman Rebecca
Published: April 2021

ABSTRACT

This study focused on applicants who were accepted to a nursing education program but did not begin their studies, thus wasting time, effort and money. Of 953 accepted applicants, 27% did not enter the program. Significant variables differentiating starters from non-starters were higher psychometric score, higher paternal education, lower priority for nursing studies, older age, non-Israeli country of birth and not completed army service. The study relating to starters vs. non-starters is one aspect of a large study (Ehrenfeld, Rotenberg, Sharon, & Bergman, 1995). In most nursing education programs the number of applicants exceed the faculty's capacity, and suitable candidates must be rejected. It is therefore both wasteful and disappointing when accepted applicants change their mind and do not actually begin in the program. In light of the costs and complexities involved in the student screening process and the continuous efforts extended today all over the world to raise the standards of nursing education and care, the factors differentiating starters from non-starters may have important implications. The aim of the present study was to evaluate the screening process at the Tel Aviv University baccalaureate nursing program and determine which variables were predictive of starters and nonstarters among accepted applicants.
Student Evaluation of Courses: Determining the Reliability and Validity of Three Survey Instruments
Authors: Jeffreys Marianne R , Massoni Margaret , O'Donnell Mary , Smodlaka Ivan
Published: April 2021

ABSTRACT

The purpose of this study was to determine the reliability and validity of three instruments designed for student evaluation of courses: the Course, Library, and Computer (CLC); the Clinical (CLIN); and the Nursing Skills Lab (NSL) evaluation tools. Using data from 294 anonymous associate degree nursing students, internal consistency and reliability were demonstrated by the high alpha coefficients ranging from .85 to .94. An exploratory principal component analysis, with the varimax rotation, provided an estimate of construct validity.
Nursing Students' Experiences Caring for Dying Patients
Authors: Beck Cheryl Tatano
Published: April 2021

ABSTRACT

Since the 1960s nurse educators have been searching for the most effective approach to prepare nursing students for care of the dying. Studies investigating the effectiveness of death education programs for nursing students have reported inconsistent findings. A phenomenological study was conducted to explore the meaning of 26 undergraduate nursing students' experiences in caring for dying patients. The nursing students' written descriptions of their experiences were analyzed using Colaizzi's (1978) phenomenological method. Six themes emerged from this analysis. While caring for dying patients, nursing students experienced a gamut of emotions such as fear, sadness, frustration, and anxiety. Contemplation of the patient's life and death occurred as the students cared for their patients. In addition to providing physical, emotional, and spiritual support for dying patients, an integral part of nursing students' care involved supporting the patients' families. Helplessness was experienced by the students regarding their role as patient advocates. While caring for dying patients, nursing students' learning flourished. Educational strategies for preparing nursing students to care for the dying are addressed based on the findings of this qualitative study.
History of Higher Education: Educational Reform and the Emergence of the Nursing Professorate
Authors: Ruby Jane
Published: April 2021

ABSTRACT

At the end of the 19th century and prior to any published nursing theories, a number of visionaries in the field of nursing were engaged in the pursuit of a liberal education for nurses. These special people, rarely considered in contemporary nursing curricula, were responsible for moving nursing education out of hospitals and into universities. This shift was primarily responsible for the development of nursing professors, which never may have developed had nursing education remained under the auspices of hospitals.
Teaching Feminist Group Process Within a Nursing Curriculum
Authors: Banister Elizabeth , Schreiber Rita
Published: April 2021

ABSTRACT

Nurse educators are challenged to develop emancipatory teaching approaches that will create opportunities for studente to develop their own praxis. In particular, the authors faced the challenge of teaching feminist group process within a curriculum based on phenomenology, feminism, and critical social theory. In this article, we discuss the challenges and rewards of teaching nursing and other students about feminist procees through the creation of experiential learning opportunities. In addition, we highlight recommendations based on our own praxis.
A Triad of Research Roles: Experiential Learning in an Undergraduate Research Course
Authors: Hitchcock Barbara Whitmeyer , Murphy Eileen
Published: April 2021

ABSTRACT

This article describes an innovative approach to teaching undergraduate research content directly involving students in a faculty research study, and a student research project undertaken in a nursing research course. Junior-level students participated as research subjects in a faculty study focusing on the health perceptions of baccalaureate nursing students, became data collectors in a related student project on the health perceptions of lay people, and became consumers of the research by analyzing the findings and clinical relevance of these studies. This strategy for teaching research assisted students to master undergraduate research content by participatory involvement in several distinct phases of the research process. The project generated considerable interest and served to foster positive attitudes toward nursing research while concurrently increasing students' comfort level with the total process.
A Survey of the Ways Master's Level Nursing Students Learn the Research Process
Authors: Bower Fay L , Timmons Mae E
Published: April 2021

ABSTRACT

Because of the need for advanced practice nurses to perform more outcome measurement, a survey was conducted in the fall of 1997 to determine how master's level students learned the research process. Three hundred four surveys were mailed to schools with master's programs, and 222 were returned for a return rate of 73%. Sixty-six percent of the programs surveyed required a thesis and/or a research project. However, there was great variation in the research projects. A comprehensive examination was used to measure research ability by 36 programs (16%), either in conjunction with a thesis or research project or alone. One hundred forty-six programs (66%) offered only one option, be it a thesis, research project, comprehensive examination, or the many other alternative activities described by respondents. Seventy-six programs (34%) offered a variety of options from which students could select. The major differences between the thesis and the research project were related to three issues: a) the nature of the supervision; b) whether the activity was an individual or group project; and c) the amount of participation of the students. Because of the variability of expectations and the ways students are taught research, it was recommended nurse educators determine whether master's level nurse graduates were prepared to conduct outcome measurement and whether the means used to teach the research process were effective considering that endeavor.
The Shifting Sands of Health Care Delivery: Curriculum Revision and Integration of Community Health Nursing
Authors: Conger Cynthia O'Neill , Baldwin Joan H , Abegglen JoAnn , Callister Lynn C
Published: April 2021

ABSTRACT

The health care delivery system in the United States is moving from an institutionally driven and controlled medical care model toward the Primary Health Care model described by the Alma-Alta Conference (World Health Organization [WHO], 1978) as community-driven comprehensive health care. However, nursing education still remains institutionally based, anchored in a medical model. Dynamic curricula must be developed that prepare nurses to practice in an ever-changing health care delivery system that is becoming more community based.

The purpose of this article is twofold: to provide an overview of the revised curriculum of Brigham Young University's College of Nursing (BYU-CON) as one example of a faculty's attempt to develop a program that prepares graduates skilled in providing health care in the 21st century; and to examine closely the integration of community health nursing into the curriculum.
Theoretical Foundations of Service-Learning in Nursing Education
Authors: Bailey Patricia A , Carpenter Dona Rinaldi , Harrington Patricia
Published: April 2021

ABSTRACT

Although somewhat new to nursing, service-learning has had a long history of development. To be successful, a service-learning program must have institutional support, interested faculty and motivated students, potential for strong community partnerships, and an ongoing orientation and development component. Reflection is an important link between the service students perform and the learning outcomes of that service.
Analysis of Differences in Entry-Level RN Practice by Educational Preparation
Authors: Smith June E
Published: April 2021

ABSTRACT

The National Council of State Boards of Nursing performs a practice (or job) analysis every 3 years linking the NCLEX-RN® to practice through assessment of current RN job tasks. Although the primary purpose of the practice analyses is validation of the examination, data also may be used to assess for differences in practice by subsets of nurses. A secondary analysis of the 1999 RN Practice Analysis was performed to explore any divergence in practice attributable to educational preparation. The average frequencies of performance of 189 nursing activities were computed separately for graduates of associate degree (ADN) and baccalaureate degree (BSN) nursing programs and compared. Results demonstrated a .98 Pearson r correlation between the averages of the two groups. Both groups performed routine nursing care activities with the greatest frequencies and demonstrated more complex or advanced skills, such as teaching and managing care, at similar lower rates. Differences in the averages between the two groups were negligible. For 144 (76%) of the activities, differences were less than .25 on a scale of 0 to 5.
Integrating Mental Illness Prevention Into Community-Based Undergraduate Education
Authors: Seed Mary St Jonn , Higgins Sally
Published: April 2021

ABSTRACT

Including preventive models of health care in undergraduate education is essential as the nursing profession moves increasingly to community-based care. Traditionally, mental health curricula have focused primarily on psychopathology. This article presents current research in the attachment and temperament literature, which provides sound evidence for the need to synthesize prevention of mental illness concepts into undergraduate education. A curriculum model that integrates concepts from psychiatry and public health to prepare nursing students to promote mental health is described.
Health Promotion and Tobacco Control: Student Nurses' Perspectives
Authors: Chalmers Karen , Seguire Marilyn , Brown Judy
Published: April 2021

ABSTRACT

This article reports findings about student nurses' understanding of the nursing role in health promotion related to tobacco issues. These findings were derived from the data of a larger project, examining smoking practices of baccalaureate nursing students in Manitoba, Canada. The study was conducted with second-year, third-year, and fourth-year university nursing students studying at several sites throughout the province (N = 272). From the data analysis of the interviews, class forums, and open-ended survey questions, five themes emerged (i.e., who they are-who they are becoming, central beliefs and attitudes, learning the facts, practice world-limited options, role conflict). Students expressed considerable uncertainty and conflict concerning individual autonomy around decisions about tobacco use. This resulted in confusion about themselves as role models and their use of health promotion interventions.
The Effect of Communication on Nursing Student Outcomes in a Web-Based Course
Authors: Frith Karen H , Kee Carolyn C
Published: April 2021

ABSTRACT

This study compared the effectiveness of different instructional communication methods in a Web-based course on students' cognitive learning, satisfaction, and motivation to complete the course. A total of 174 undergraduate nursing students were selected randomly and assigned to experimental or control groupe. Instruments included a demographic data form, two examinations on course material, a course satisfaction scale, and calculation of completion rates. All students received identical didactic Web-based instructional materials. However, type of communication varied among groups.

No significant group differences were found for cognitive learning or motivation to complete the course. A significant group difference was found for student satisfaction with the course, indicating carefully planned communication strategies can improve satisfaction. A need for technical support also was evident. More research is needed to determine the best strategies to enhance student learning outcomes and decrease student attrition in Web-based courses.
Pacific Coast Oto-Ophthalmological Society
Authors: Morgan George E
Published: April 2021

REPORT ON MEETINGS
Descemet's Membrane Tubes
Authors: Wolter J Reimer
Published: April 2021

On The Zonular Fibers of the Lens
A Performance Test to Accompany Ophthalmic Examination in the Young School Age Child: The "Draw A Bicycle" Test
Authors: Helveston Eugene M , Ellis Forrest D , Weber Janet C , Helveston Barbara H , Miller Kathleen
Published: April 2021

ABSTRACT

A performance test is proposed as an addition to the routine eye examination of the child performing poorly in school. Performance on the "draw a bicycle test" has a strong correlation with academic performance among children in grades one through three. Poor performance on the "draw a bicycle test" by children who have otherwise normal eye findings implicates a non ocular cause for the poor academic performance. Since the results of this simple test are immediately visible and readily understood by an attending parent, the ophthalmologist's role in counseling the parents against further ocular investigation and therapy is apparent.
Wegener's Granulomatosis Presenting as Orbital Pseudotumor in Children
Authors: Parelhoff Edward S , Chavis Richard M , Friendly David S
Published: April 2021

ABSTRACT

The case of a nine-year-old white female who presented initially with idiopathic inflammatory pseudotumor and was ultimately diagnosed (22 months later) as having Wegener's granulomatosis is presented. A review of the literature reveals that, to date, there are 21 well-documented cases of Wegener's granulomatosis occurring in children under the age of 16. Of these 21 cases, eight patients (39%) manifested ocular or orbital signs during the course of the disease. Four of these cases (50%) presented initially with idiopathic inflammatory pseudotumor. The diagnosis of Wegener's granulomatosis should be considered in children with orbital pseudotumor. Long-term follow-up may be necessary to exclude this possibility.
The Role of Ocular Torsion on the Etiology of A and V Patterns
Authors: Kushner Burton J
Published: April 2021

ABSTRACT

Theoretically, the torsion of the globe produced by primary oblique overaction results in a vertical displacement of the insertions of the horizontal recti and a horizontal displacement of the insertions of the vertical recti. This should alter the vectors of the forces exerted on the globe by the rectus muscles so that the horizontal recti become partial elevators or depressors and the vertical recti become increasing abductors or adductors. This change in force vectors tends to enhance the A or V pattern that results from oblique dysfunction. I propose that the etiology of A and V patterns is the result of a complex interplay between all of the extraocular muscles and present a clinical series to suggest the validity of that theory.
Retinal Vascular and Optic Nerve Abnormalities in Albinism
Authors: Spedick Michael J , Beauchamp George R
Published: April 2021

ABSTRACT

Albinism is a condition in which the pigment melanin may not be synthesized from tyrosine. The fundus photographs of 24 eyes of 12 patients with the clinical diagnosis of either ocular or oculocutaneous albinism were reviewed. We observed two findings that to our knowledge have not been reported previously. Eighteen eyes often patients had prominent retinal vessels coursing through the putative macular area instead of arching around it. Large noncilioretinal vessels extended from the disc to the dysplastic "foveal zone" in eight eyes of five patients. Typical optic nerve hypoplasia (ONH) was seen in six eyes of four patients; features suggestive of ONH were present in an additional ten eyes of six patients. The cross-over (sharing) of clinical features between albinism and aniridia is striking and raises questions about pathophysiologic mechanisms.
Topographical Aspects of the Insertions of the Extraocular Muscles
Authors: Souza-Dias Carlos , Preto-Diaz Julio , Uesugui Carlos F
Published: April 2021

ABSTRACT

In 581 strabismus operations, the distances between the limbus and the scleral insertions of the rectus muscles were measured, as well as the distances between the anterior end of the insertions of the superior and the inferior obliques and the temporal end of the insertion of the superior rectus and the inferior end of the one of the lateral rectus, respectively.

In the case of the rectus muscles, smaller values than the classical ones were found. With the obliques, the measurements were similar to those of Fink.

The differences with age or refraction were not statistically significant. We concluded that these parameters are not important in the determination of the amount of recession of an extraocular muscle in strabismus operations in patients over the age of six months.
A Comparison of the Pupillary and Cardiovascular Effects of Various Mydriatic Agents in Preterm Infants
Authors: Sindel Bruce D , Baker M Douglas , Maisels M Jeffrey , Weinstein Joel
Published: April 2021

ABSTRACT

We conducted a randomized, masked study of pupillary dilating capabilities and associated cardiovascular effects of three solutions. Thirty-four babies <1500 grams at birth were studied at six to eight weeks. Group A (n=10) received phenylephrine (PE) 2.5% and tropicamide 1.0%; Group B (n=10) PE 2.5%, tropicamide 0.5%, and cyclopentolate 0.5%, Group C (n=10) PE 1.0% and tropicamide 1.0%; Group D (n=4) saline 0.9%. One drop was placed in each eye and repeated five minutes later. Pupillary dilation was measured with a metric ruler by direct observation at one hour. Blood pressure (BP) and heart rate (HR) were monitored, using an oscillometer, immediately prior to the instillation of the drops and at five-minute intervals, for 60 minutes. BP and HR increased transiently in all groups receiving mydriatics but returned to baseline values in 25 minutes. This increase was significant in Groups A and B (2.5% PE: p<0.02). Group D (saline) showed no change in BP or HR. Postdrop pupillary size was largest in Group A but the differences were not significant. On exposure to bright light, the pupillary size in Group C was significantly smaller than Groups A or B (7.35 ± 0.59 mm, 7.23 ± 0.38 mm and 6.75 ± 0.57 mm in Groups A, B and C, p<.01). Nevertheless, dilation was sufficient to allow appropriate examination in all infants (pupillary diameter >6.0 mm). Solutions containing 2.5% PE are most effective for use in LBW infants, but produce cardiovascular effects. Solutions containing 1% PE provide adequate dilation with minimum cardiovascular effects.
Stereopsis Testing in a Preschool Vision Screening Program
Authors: Ruttum Mark S , Bence Susan M , Alcorn Deborah
Published: April 2021

ABSTRACT

We conducted a preschool vision screening study using stereopsis testing with the Random Dot E and Lang stereotests as a complement to visual acuity measurement. Over 6000 children were screened. Stereopsis testing at a threshold of 600 seconds of arc was cognitively easier for the children than visual acuity measurement. At this threshold there was no effect on reducing the rate of visual acuity overreferrals, but ten children with abnormal binocular vision were detected who were not referred by visual acuity criteria. Though a large number of children passed only one of the two stereotests, there was no significant difference in their degree of difficulty. Stereopsis testing with these two stereotests may be a useful adjunct to preschool vision screening programs though further studies are required.
Acquired Brown's Syndrome From Blunt Orbital Trauma
Authors: Baker Robert S , Conklin John D
Published: April 2021

ABSTRACT

Blunt trauma to the supero-medial orbit resulted in an isolated Brown's syndrome in two patients. One recovered spontaneously in three weeks; the other had a good outcome after surgery two years post trauma. Recognition of the characteristic motility abnormality and forced duction testing will differentiate this condition from other, more common, motility disorders caused by orbital trauma.

Spontaneous resolution may occur but in persistent deviations a superior oblique muscle weakening procedure should be considered.
Progressive Hemifacial Atrophy (Parry-Romberg Disease)
Authors: Miller M T , Sloane H , Goldberg M F , Grisolano J , Frenkel M , Mafee M F
Published: April 2021

ABSTRACT

Hemifacial atrophy (Parry-Romberg syndrome) is characterized by slowly progressive atrophy of one side of the face, primarily involving the subcutaneous tissue and fat. The onset is usually in the first two decades. Ophthalmic involvement is common; the most frequent abnormality is progressive endophthalmos with subsequent changes in the palpebral fissure. Pupillary disturbances, heterochromia, uveitis, and restrictive strabismus have also been frequently reported.

We describe six cases that manifest a wide spectrum of ocular and systemic findings. They are noteworthy in that all exhibit pigmentary disturbances of the ocular fundus, a finding rarely reported. Another unusual ocular manifestation in one patient was an acquired partial third nerve palsy on the unaffected side.
Epidemiology of Retinal Detachment in Childhood and Adolescence
Authors: Rosner Mordechai , Treister Giora , Belkin Michael
Published: April 2021

ABSTRACT

The prevalence of retinal detachment during childhood and adolescence was studied in 45,000 recruits aged 17 to 19 years. History of retinal detachment was found in 13 cases (0.028%); 61.5% of these had traumatic retinal detachment, and 23.1% had high myopia without history of trauma. The age-related annual incidence of retinal detachment in patients aged ten to 19 years was calculated to be 2.9 per 100,000. The prevalence among the males was 3.7 per 10,000 and among the females 1.6 per 10,000. The difference between the sexes was not statistically significant.
Familial Iridoplegia
Authors: Hersh Joseph H , Douglas Craig , Houston John , Weisskopf Bernard
Published: April 2021

ABSTRACT

Fixed, dilated pupils in childhood are usually due to interruption of parasympathetic innervation as a result of neurologic impairments or occur following pharmacologic mydriasis. We present a familial form of iridoplegia without structural defects of the eye which is consistent with a probable autosomal dominant mode of inheritance. Examination of other family members should be part of an affected individual's evaluation particularly when this finding occurs as an isolated defect. Recognition of such an entity may avoid unnecessary neurodiagnostic studies in an affected individual.
Isolated Orbital Roof Fracture With Traumatic Encephalocele
Authors: Greenwald Mark J , Lissner Gary S , Tomita Tadanori , Naidich Thomas P
Published: April 2021

ABSTRACT

Several months after a fall down a flight of stairs, a one-year-old girl developed downward displacement and pulsation of the left eye. Vision and ocular motility were not impaired and the child remained neurologically normal. Computed tomography with metrizamide cisternography demonstrated herniation of brain tissue through a traumatic defect in the roof of the orbit. The orbital rim and other craniofacial bones were intact. Repair of the growing fracture found at operation restored normal appearance without disturbing function. To our knowledge, this is the first documented case of encephalocele associated with an isolated fracture of the orbital roof due to blunt head trauma.
The Investigation and Management of Torsion Preventing Fusion in Bilateral Superior Oblique Palsies
Authors: Pratt-Johnson J A , Tillson G
Published: April 2021

ABSTRACT

Fifteen patients with bilateral superior oblique palsy were studied with respect to the influence of torsion on fusion with amplitudes. The Clement Clarke Synoptophore was used to record torsion and examine fusion. Nine patients needed the correction of torsion preoperatively to fuse in the primary position. Three patients had central fusion disruption. Torsion in excess of 10° or bilateral excyclotorsion were present in most patients who required torsion correction for fusion with amplitudes. All patients had surgery. The effects, at least three months after surgery, are discussed. Some residual excyclotorsion remained in most cases and appears to be compatible with a good fusional result and an average field of single binocular vision of 30°.
Artifacts of Measuring During Strabismus Surgery
Authors: Kushner Burton J , Preslan Mark W , Vrabec Michael
Published: April 2021

ABSTRACT

Several different artifacts can induce errors in measurements obtained during strabismus surgery.

Fixating the severed rectus muscle stump with forceps during strabismus surgery can result in a temporary anterior displacement of the insertion. This may result in inaccuracies in determining the site to which the muscle is to be recessed. This displacement was quantified in a prospective masked manner and was found in some patients to result in as much as 1 mm of error. It can be prevented by measuring the recession prior to fixating the insertion stump with forceps; however, it cannot always be prevented by measuring from the limbus, which also introduces other artifacts due to geometric principles.

An "advancement effect" occurs during a rectus muscle recession due to the mechanics of suture placement in the muscle. It was quantified in a masked manner and found to be approximately .5 mm in most cases.

A "V" shaped deformity of the insertion stump may occur immediately adjacent to the forceps. This deformity frequently distorts the insertion by as much as several millimeters.
An Investigation of the Clinical Use of Botulinum Toxin A as a Postoperative Adjustment Procedure in the Therapy of Strabismus
Authors: McNeer Keith W
Published: April 2021

ABSTRACT

Attempts to circumvent multiple surgical procedures are an integral part of the history of investigations in strabismus. In 1973, Botulinum toxin A (Oculinum®) injections into human EOM was proposed as an alternate method to surgery for strabismus and has since proved to be effective. This article reports the results from a retrospective investigation of EOM Oculinum injection used in the postoperative period as an alternate to additional surgery. It is difficult to establish whether Oculinum altered the time span of the clinical course in these patients, but when It was effective, it provided unprecedented convenience.
Monocular Eye Closure in Sunlight
Authors: Wiggins Robert E , von Noorden Gunter K
Published: April 2021

ABSTRACT

Monocular eye closure in sunlight is often noted in patients with intermittent exotropia. Neither the reason for eye closure nor its frequency of occurrence in other populations is known. We questioned 147 consecutive nonoperated patients (and/or their parents) ages 1-45 years, 93 with strabismus with onset prior to 7 years of age and 54 without strabismus, for a history of closing one eye in sunlight. Monocular eye closure in sunlight was reported most frequently by patients with intermittent exotropia but was also reported by those with other forms of strabismus as well as by nonstrabismic normals. Cooperative subjects were studied further to determine the cause for eye closure. Each subject was exposed to a source of intense illumination while fixating a target. All who closed one eye under these conditions reported photalgia associated with the high light intensity, most noting less discomfort after closing one eye. None reported diplopia prior to eye closure. Monocular and binocular photophobia thresholds were then measured for each subject The mean monocular photophobia threshold was significantly higher than the binocular threshold. In addition, binocular photophobia thresholds were significantly lower in those reporting eye closure compared with those who did not Monocular eye closure in sunlight is a mechanism used to reduce photophobia and is not related to avoidance of diplopia.
The Visually Inattentive Preterm Infant
Authors: Kivlin Jane D , Bodnar Anna , Ralston Charles W , Hunt Steven
Published: April 2021

ABSTRACT

A retrospective study was made of 16 premature infants who were visually inattentive despite normal eye findings and a lack of factors predisposing them to cerebral blindness, A comparison of this study group with other premature infants who were visually attentive revealed a much greater incidence of upper motor neuron disease and mental retardation in the study infants.
Characteristics of Two New Retinoblastoma Cell Lines: WERI-Rb24 and WERI-Rb27
Authors: Sery Theodore W , Lee Eva Y-HP , Lee Wen-Hwa , Bookstein Robert , Wong Vernon , Shields Jerry A , Augsburger James J , Donoso Larry A
Published: April 2021

ABSTRACT

From 49 eyes enucleated for retinoblastoma, two new cell lines, WERI-Rb24 (W-24) and WERI-Rb27 (W-27), were established in long-term culture (>5 years). The W-24 cell line was derived from a 22-month-old boy with sporadic retinoblastoma; the W-27 cell line was derived from a 24-month-old boy with bilateral retinoblastoma. Both cell lines show abnormal mRNA transcripts corresponding to the retinoblastoma gene. At the DNA level, one retinoblastoma allele was not present in the W-24 cell line. In the W-27 cell line a mutation was identified in one allele, while the other appears grossly normal. Since no normal retinoblastoma mRNA can be detected in either cell line, a subtle mutation must occur on the grossly normal allele. Comparison of DNA in W-27 lymphocytes and tumor cells with DNA probe p6NR-0.5 indicates that the observed mutation occurred somatically. The application of these two new retinoblastoma cell lines to the characterization of defects in the retinoblastoma gene and to gene replacement therapy in retinoblastoma is discussed.
Erroneous Findings in Polarized Testing Caused by Plastic Prisms
Authors: Frantz Kelly A , Cotter Susan A , Brown William L , Motameni Mercedeh
Published: April 2021

ABSTRACT

Certain plastic prisms, when used with polarized tests (eg, stereopsis), can destroy the uniqueness of each eye's view. We investigated this effect by administering the Randot stereotest to 12 visually normal observers. The test was administered monocularly (simulating suppression), under habitual conditions, and through six representative prisms, both fused and monocularly. Whereas stereo thresholds with an anaglyphic random dot stereogram (TNO) were not significantly affected by the prism, fusing through some of the prisms resulted in significantly poorer stereo thresholds and a failure to detect random dot stereopsis (RDS) on the polarized stereotest. Furthermore, some subjects appreciated RDS viewing monocularly through each of the prisms. Thus, it is important to conduct polarized testing through prisms that are known not to interfere with polarization. This optical phenomenon is explained here.
Atropine Cycloplegia: How Many Instillations Does One Need?
Authors: Stolovitch Chaim , Loewenstein Anat , Nemmet Pinchas , Lazar Moshe
Published: April 2021

ABSTRACT

Atropine is accepted generally as the most efficient cycloplegic agent. Although it is considered a relatively safe drug, toxic local and systemic side effects do occur. The recommended regimen for atropine cycloplegia has been 7 to 10 applications within 3 to 4 days. We compared the cycloplegic effect of four instillations of atropine drops to the effect of eight instillations. The results showed that the cycloplegia obtained after eight instillations was not greater than after four instillations.
Enucleation Technique for Children With Retinoblastoma
Authors: Shields Jerry A , Shields Carol L , De Potter Patrick
Published: April 2021

ABSTRACT

Based on personal experience with approximately 350 enucleations for retinoblastoma, the authors describe their current surgical technique for removal of the eye, opening the globe to harvest fresh tissue for research including DNA analysis, and placement of the new hydroxyapatite orbital implant. Enucleation should be performed as gently as possible. A hemostat Is placed on the stump of the severed medial rectus muscle for traction purposes, and long, minimally curved scissors are used to cut the optic nerve near the orbital apex. Clamps and snares are not advised and cautery of the orbital tissue is avoided. A piece of optic nerve is first submitted separately for histopathologic study and the globe is opened with a specific technique to harvest fresh tumor tissue. A hydroxyapatite implant covered by sterilized sclera is placed in the anophthalmic socket to provide orbital volume and improved motility of the prosthesis.
Central Nervous System Involvement in Leber Congenital Amaurosis
Authors: Steinberg Avraham , Ronen Suzy , Zlotogorski Zoli , Silverston Ben-Zion , Hirsch Israela , Nawratzki Ilse
Published: April 2021

ABSTRACT

Sixteen patients with ocular criteria of Leber congenital amaurosis (LCA) were studied. Neurological examination was normal in 11 of 16 patients. The electroencephalogram was normal in six of eight patients, while two had nonspecific theta slowing. Computerized tomography of the brain was normal in two of five; hypoplasia of the cerebellar vermis was seen in one, and mild to moderate ventriculomegaly was seen In two of five. Six patients underwent the verbal subtests of the Wechsler Intelligence Scale and a detailed battery of neuropsychological tests. Subtests dependent on early environmental influences were most severely affected, while culture-free subtests showed average or well above average performance.

These results strongly support the hypothesis that children with LCA may be capable of normal cognitive functioning, although they perform poorly on standard IQ tests. This is related to their early environmental and sensory deprivation, rather than to a primary central nervous system dysfunction.
Multifocal Versus Monofocal Correction of Neonatal Monocular Aphakia
Authors: Lambert Scott R , Fernandes Alcides , Drews-Botsch Carolyn , Boothe Ronald G
Published: April 2021

ABSTRACT

We compared the efficacy of monofocal and m u Iti foe a I intraocular lenses (IOLs) as a means of optically rehabilitating eyes with monocular congenital cataracts using a primate model. A congenital cataract was simulated m the right eye of 20 monkeys from birth to 2 weeks of age with an opalescent contact lens. A lensectomy was then performed and a monofocal IOL was implanted in 11 eyes and a multifocal IOL in 9 eyes. Any residual refractive error was then corrected with an extendedwear contact lens.

The fetlow eyes were then randomized to no treatment or 70% occlusion therapy. Grating acuity was assessed using forced-choice preferential looking with Teller acuity cards at regular intervals. At 32 weeks of age, the pseudophakic eyes were mildly amblyopic, but the grating acuities were not significantly different between the pseudophakic eyes with multifocal versus monofocal IOLs or between subjects who had received occlusion therapy versus no treatment of the fellow eye. We conclude that at least through 32 weeks of age, multifocal and monofocal IOLs are of similar efficacy and occlusion therapy may be less important to prevent amblyopia from developing in pseudophakic eyes compared to contact-lens corrected aphakic eyes.
Peroxisomal Bifunctional Enzyme Complex Deficiency With Associated Retinal Findings
Authors: Eustis H Sprague , Curry Thomas , Superneau Duane W
Published: April 2021

ABSTRACT

Peroxisomal bifunctional enzyme complex deficiency is a recently recognized abnormality of fatty acid metabolism. We herein present the association of a flecked retina with peroxisomal bifunctional enzyme deficiency, a clinical association not previously reported. We suggest the finding of a flecked retina in an infant presenting with hypotonia, seizures, and failure to thrive is highly suggestive of this diagnosis.
Measurement of Low Vision in Advanced Cicatricial Retinopathy of Prematurity
Authors: Droste Patrick J , Trese Michael T
Published: April 2021

ABSTRACT

This study evaluates functional vision in visually impaired children with stage IV to V cicatricial retinopathy of prematurity (CROP) by comparing results derived from the Teller acuity cards and a battery of behavioral tasks, the visual function battery (VFB). Vision was evaluated in 26 eyes of 15 children ages 6 months to 14 years, who underwent retinal reattachment procedures for active stage IV and stage V retinopathy of prematurity. Results showed that 10 of 26 eyes (38%) had a recordable grating acuity to Teller acuity card assessment. Twenty-five of 26 eyes (96%) showed a response to the VFB. Sixteen of 26 eyes (62%) showed recordable scores with the VFB but no corresponding scores with the Teller acuity cards. The VFB may be more reliable than the Teller acuity cards in measuring visual function in the very low acuity range.
Posterior Chamber Intraocular Lenses: Long-Term Results in Pediatric Cataract Patients
Authors: Crouch Earl R , Pressman Scott H , Crouch Eric R
Published: April 2021

ABSTRACT

Major problems in pediatric cataract patients include noncompliance with contact lenses resulting in amblyopla. Advances in intraocular cataract surgery have provided a better environment to perform intraocular lens (IOL) implantation in children. We prospectively analyzed the results of 34 consecutive pediatric patients who underwent cataract removal and insertion of an IOL. Operative technique performed was posterior scleral beveled or frown incision and IOL endocapsular fixation. Subgroups included 10 eyes with traumatic cataract, and 24 eyes with developmental cataracts. Six patients had bilateral IOLs.

Data presented in each subgroup included initial and final visual acuity, age, sex, type of cataract, A and B scan biometry, early and late postoperative complications, time of YAG capsulotomy, postoperative refractive correction, and state of binocular vision.

Preoperative visual acuity ranged from 20/70 to light perception. The success rate for postoperative visual acuity of 20/40 or better occurred in 29 of 34 eyes, or 85.3%. In the traumatic cataracts, 8 of 10 eyes (80%) obtained 20/40 vision or better. In developmental cataracts, 21 of 24 eyes (88%) achieved visual acuity of 20/40 or better. Amblyopia (three patients) or macular scar (two patients) accounted for reduced visual acuity in the five eyes with vision less than 20/40.

Early complications included posterior synechiae and lens deposits. The primary late complication was opacification of the posterior capsule in 18 of 34 eyes. The average time for YAG capsulotomy post-cataract removal was 17 months. None of the 28 patients (34 eyes) developed glaucoma, IOL dislocation, or other significant postoperative problems related to IOL insertion.

Modern cataract surgery with posterior scleral beveled or frown incision and IOL fixation in the capsular bag is a safe, effective method of obtaining useful vision in pediatric patients ages 2 to 18.
Ultrastrucure of the Superior Oblique Tendon
Authors: Helveston Eugene M , Oberlander Mark , Evan Andrew , Connors Bret , Clendenon Jeff
Published: April 2021

ABSTRACT

Individual collagen fibers in the superior oblique tendon of patients with superior oblique palsy studied at 60 000x with transmission electron microscopy are fewer in number and larger in diameter when compared to normal fibers. The relationship of these changes to function and to gross morphologic changes are not clear.
Electrophysiological and Eye-Movement Abnormalities in Children With the Bardet-Biedl Syndrome
Authors: Lavy Timothy , Harris Christopher M , Shawkat Fatima , Thompson Dorothy , Taylor David , Kriss Anthony
Published: April 2021

ABSTRACT

We investigated 17 patients with clinical features of Bardet-Biedl syndrome by electroretinogram (ERG), visual-evoked potentials (VEP), and electro-oculographic (EOG) eye movement assessment. The ERGs were grossly abnormal in 16 cases. Pattern VEPs were generally well preserved, but showed a tendency to increase in latency and decrease in amplitude with age.These results confirm other reports that the retinopathy appears to be a progressive rod-cone dystrophy initially affecting mainly extramacular areas but involving the macula at later stages. Seven of 11 patients showed abnormalities of either optokinetic nystagmus, vestibulo-ocular reflex, or both. These eye-movement abnormalities have not been reported previously, and are further evidence of central nervous system involvement in this syndrome.
Intellectual and Educational Attainment in Albinism
Authors: Fulcher Tim , O'Keefe Michael , Bowell Roger , Lanigan Bernie , Burke Teresa , Carr Alan , O'Rourke Marie , Bolger Maeve
Published: April 2021

ABSTRACT

We studied the intellectual and educational ability of a group of 18 albino children as compared with that of a group of demographically matched controls. Intellectual ability was measured using Raven's Standard Progressive Matrices, and educational ability was measured by the reading, spelling, and arithmetic tests of the Wide Range Achievement Test. There was no statistically significant difference in intelligence of the two groups. However, there was a significant difference in reading, spelling, and arithmetic skills. No correlation was found between the clinical features of the albino children and their performance on the intelligence or educational tests.
A Comparison of Wright Card With Teller Card for Detection of Amblyopia
Authors: Raina Jyoti
Published: April 2021

ABSTRACT

Purpose: Teller acuity cards are used to assess visual acuity in infants but can underestimate amblyopla. In order to improve amblyopia detection, a new luminance balanced checkered card of 4.8 cycles/cm frequency was developed by Wright and Vistech (Dayton, Ohio). The Wright card was compared with a corresponding Teller card (of 4.8 cycles/cm) for detection of amblyopia.

Methods: A prospective masked study of 44 children was carried out. Each was assessed for amblyopia using both the Wright and Teller cards in addition to the Snellen or Alien card (optotype).The results were analyzed statistically using repeated measures of ordinal data.

Results: Thirteen eyes were found to be amblyopic with optotype testing, two with the Teller card and 17 with the Wright card. With optotype acuity as the standard, the sensitivity and specificity of the Teller card was 15.3% and 1 00%, while that of the Wright card was 1 00% and 94.6%.

Discussion: The Teller card Is associated with high false negative test rate because it assesses grating acuity and allows spurious resolution possibly due to an edge artifact. This artifact is less pronounced with the Wright card. Further, the stripes on the Teller card require resolution only In horizontal axis, while the checkers requires uniform resolution in all axes. Different pathways for neural processing may also contribute to the disparate results with these methods.

Conclusions: The Wright card was more sensitive than the Teller card for the detection of amblyopla In this study population and has potential value in preverbal children.
Electroretinographic Findings in Infants With the Shaken Baby Syndrome
Authors: Fishman Craig D , Dasher William B , Lambert Scott R
Published: April 2021

ABSTRACT

Purpose: To determine if electroretinography Is helpful in the work-up of children with the shaken baby syndrome.

Methods: Six children with retinal hemorrhages and the shaken baby syndrome underwent electroretinography (ERG). The ERGs of these six children were compared with six age-matched controls using the sign-rank test.

Results: Neither the implicit time nor the amplitude of the white scotopic ERG response was significantly different between these patients and age-matched controls. Although the amplitude of the blue scotopic and 30 Hz flicker responses were attenuated (p<.05), the implicit times were not significantly different from controls. Three of the patients had serial ERGs recorded. The b-wave implicit time and amplitude Improved in two of these patients. The ERG was helpful in distinguishing between a CNS and a retinal cause of visual loss in one child.

Conclusions: The ERG can be helpful in assessing retinal function in children with the shaken baby syndrome who have persistent visual impairment. In most cases, the ERG is not helpful in the initial assessment of children with the shaken baby syndrome.
Can Congenital Nasolacrimal-duct Obstruction Interfere With Visual Development? A Cohort Case Control Study
Authors: Ellis John D , MacEwen Caroline J , Young James D H
Published: April 2021

ABSTRACT

Purpose: To ascertain if tear film disturbance in congenital nasolacrimal-duct obstruction (CNLDO) interferes with visual maturation.

Methods: Review of a cohort of children in which the occurrence and duration of CNLDO had been previously documented. Information obtained included acuity, refractive data, and presence or absence of strabismus. The incidence of abnormality in the CNLDO group was compared with that in controls, which were fellow eyes in those children with unilateral obstruction, and all children with no history of CNLDO.

Results: Of 4792 children, visual acuity data were obtained on 2249. There was no difference in the incidence of amblyopia in CNLDO children compared with controls (pcO.89) nor in the watering eye compared with the fellow eye (p<0.58). No correlation between refractive error or astigmatism and CNLDO (p<0.26 and p<0.32 respectively) was found. Strabismus was no more common in CNLDO than in controls (p&lrt;0.89).

Conclusions:This study found no evidence to suggest that visual maturation is adversely affected by allowing spontaneous resolution of CNLDO.