bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of Bacterial Culturing in the Course of Congenital Nasolacrimal Duct (NLD) Obstruction
Authors: MacEwen Caroline J , Phillips M Gabby , Young James D H 
Published: April 2021

ABSTRACT
The role of infection in the etiology and persistence of congenital nasolacrimal duct (NLD) obstruction is examined in a group of 334 infants who had conjunctival swabs cultured. One hundred and fifty eight (47%) of these had evidence of NLD obstruction and 176 (53%) did not. The types of organism grown from those with and without NLD obstruction were similar and occurred in almost equal proportions in each group. In addition, the rate of spontaneous resolution in those with NLD obstruction was the same, whether pathogenic bacteria were grown or not. There were no cases of orbital cellulitis, dacryocystitis, or ocular infection in those with NLD obstruction and no suggestion that secondary infection was more common in this group.
A New Scleral Depressor for Extremely Premature Infants
Authors: Karaki Takeshi 
Published: April 2021

ABSTRACT
A new scleral depressor has been designed that enables easy insertion into a small conjunctival sac, facilitating examination of the ocular fundus in extremely premature infants with retinopathy of prematurity. This new scleral depressor is also useful in mature infants and children.
Magnetic Resonance Imaging of the Superior Oblique Muscle in Superior Oblique Myokymia
Authors: Mehta Ashish M , Demer Joseph L 
Published: April 2021

ABSTRACT
High resolution, magnetic resonance imaging was used to quantitatively study the morphometry of the superior oblique muscles of two patients with superior oblique myokymia, as well as 18 superior oblique muscles of 14 patients with normal superior oblique function. The cross sectional area of each superior oblique muscle was measured at 3-millimeter intervals along the entire muscle length. In both cases of myokymia, the affected superior oblique muscles were significantly smaller than normal (P < .05).
These anatomical changes in the superior oblique muscle of patients with myokymia suggest that an antecedent injury to the trochlear nerve has occurred. This injury, even if clinically unapparent, may be the initial event which leads to subsequent development of superior oblique myokymia.
Ophthalmoscopic Evolution of Papillary Colobomatous Malformations
Authors: Gornés Pedro A Villalonga , Terraza Alicia Galan , Gil-Gibernau Juan J 
Published: April 2021

ABSTRACT
We describe congenital colobomatous malformations of the optic nerve and the clinical variations and complications that may appear eventually in them. We also present two clinical cases of patients with papillary colobomatous defects where spontaneous variations have been observed throughout their evolution and where the current Ophthalmoscopic aspect is completely different from the initial one. Finally, bearing in mind the embryologie origin and histologie structure of these anomalies, we develop a hypothesis that explains the physiopathologic mechanism that causes the clinical changes described in each case.
Steroid Injection Versus Conservative Treatment of Anisometropia Amblyopia in Juvenile Adnexal Hemangioma
Authors: Motwani Manoj V , Simon John W , Pickering J Dawn , Catalano Robert A , Jenkins Paul L 
Published: April 2021

ABSTRACT
Because of serious side effects, the indications for intralesional steroid injection of adnexal hemangiomas are unclear. Of 23 children with such lesions who were examined over a period of 9 years, 9 had no evidence of amblyopia and needed no intervention. Five required steroids intralesionally and/or systemically because of threatened occlusion of the pupillary axis. The remaining 9 were considered at risk of anisometropic amblyopia because of induced astigmatism: 5 received injections and 4 were treated with glasses and/or patching alone. The visual, refractive, and cosmetic results of the injected and conservatively managed anisometropes were simitar. We recommend that steroid injection be reserved for patients with threatened occlusion of the visual axis and for those with severe astigmatism or amblyopia refractory to conservative management.
The Predictive Value of Posterior Pole Vessels in Retinopathy of Prematurity
Authors: Saunders Richard A , Bluestein Ettaleah C , Sinatra Robbin B , Wilson M Edward , O'Neil James W , Rust Phillip F 
Published: April 2021

ABSTRACT
Dilation and tortuosity of the posterior pole vessels "(plus disease)" is a sign of poor prognosis and may be associated with threshold or prethreshold retinopathy of prematurity (ROP). We have found that normal posterior pole vessels are a reliable marker for the absence of stage 3 ROP. One hundred thirty-two consecutive premature infants weighing less than 1600 g at birth underwent ROP examinations between 32 and 40 weeks' postconceptional age. The status of the posterior pole vessels was compared to peripheral retinal pathology. Vascular findings in the posterior pole were graded 0, 1, 2, or 3, with 0 representing normal arterioles and venules and 3 representing plus disease. The remainder of the fundus examination was recorded using the International Classification of ROP, then converted to a severity scale based on zone and stage of ROP. For each infant, only one examination representing the most severe stage of ROP reached prior to treatment or spontaneous regression was used for data analysis. There was a highly significant Spearman's rank correlation (r^sub s^ = 0.65) between the posterior pole vascular abnormalities and the severity of ROP in the retinal periphery. Clinically important ROP was not found in any patient with normal posterior pole vessels (grade Q) and stage 3 disease was usually associated with both venous and arterial vascular abnormalities (grades 2 or 3). When ocular examination of premature infants is difficult because of poor dilation of the pupil, hazy media, or medical instability, normal appearance of the posterior pole vessels can be a reassuring finding if it is necessary to postpone complete fundus examination in infants at risk for ROP.
Upper Age Limit for the Development of Amblyopia
Authors: Keech Ronald V , Kutschke Pamela J 
Published: April 2021

ABSTRACT
The medical records of 64 patients between 1 and 11 years old with known onset of an amblyopia-induclng condition were retrospectively reviewed to determine the upper age limit for the development of amblyopia. Thirty seven patients (group 1) developed amblyopia and 27 patients (group 2) did not. The mean patient age at the onset of the amblyopia-inducing condition was 41.0 months (2.90 SE) for group 1 and 92.3 months (4.02 SE) for group 2. The difference was statistically significant (P=. 0001). No patient developed amblyopia after 73 months of age. The duration of the amblyopia-inducing condition and the type of amblyopia-inducing condition were not significantly different between the two groups.
The age of the patient when exposed to an amblyopiainducing condition is the most important determinant for the development of amblyopia. Patients 6 years or older with a normal visual system have a low probability of developing amblyopia following the onset of an amblyopia-inducing condition.
Unusual Presentation of Advanced Coats' Disease
Authors: Patel Hitesh K , Augsburger James J , Eagle Ralph C 
Published: April 2021

ABSTRACT
The authors report the case of a 19-month-old boy with advanced Coats' disease whose presenting manifestation was turbid, lipoproteinaceous fluid filling the anterior chamber. The possible sites of origin and routes of migration of the turbid fluid into the anterior chamber are discussed.
Subretinal Neovascularization in Children and Adolescents
Authors: Goshorn Erin Booher , Hoover Darren L , Eller Andrew W , Friberg Thomas R , Jarrett William H , Sorr Edward M 
Published: April 2021

ABSTRACT
Subretinal neovascular membranes (SRNVM) in the pediatric population are rare. The clinical presentation, etiology, course, and management of SRNVM in 25 children (27 eyes) were studied retrospectively. Inflammatory or infectious conditions predominated (10 of 25). Eleven of 19 untreated SRNVM (58%) spontaneously involuted, with 9 of these 11 achieving a final visual acuity of 20/50 or better. A hyperpigmented ring on fluorescein angiography was associated with 9 of the 1 1 involuted SRNVM. The presence of this pigmented ring may help to identify those cases with a better visual prognosis.
Results of Treatment of Superior Oblique Overaction by Silicone Tendon-Expander Technique
Authors: Seawright Ashley A , Gole Glen A 
Published: April 2021

ABSTRACT
Purpose: To report the results of treatment of a series of patients with superior oblique overaction using the superior oblique silicone tendon-expander technique.
Methods: A chart review of 17 patients with superior oblique overaction who had a total of 26 silicone tendonexpander procedures was conducted.
Results: Mean preoperative degree of superior oblique overaction was +2.7. 92% of eyes had mild (+1) or no residual overaction at last postoperative assessment (follow-up range: 6 to 59 months). Of 15 patients with preoperative ?-pattern of 10 prism diopter (A) or more, only two patients (1 3%) had ?-pattern of 1 0 ? or more at last assessment. Of 13 patients with preoperative hypotropia in primary position, five patients (38%) had no vertical deviation in primary position, and seven patients (54%) had persistent, but less vertical deviation in primary position at last assessment (mean reduced from 11Δ to 4Δ). No patient manifested superior oblique palsy at their last postoperative assessment.
Conclusions: We believe that the superior oblique tendon-expander technique should be strongly considered for the treatment of superior oblique overaction associated with ?-pattern or hypotropia In primary position, because it has a high success rate and a low incidence of postoperative complications. Consecutive superior oblique underaction did not occur In this series.
Clinicopathologic Factors Related to Metastasis in Retinoblastoma
Authors: Wang An-Guor , Hsu Wen-Ming , Hsia Wei-Wei , Liu Jorn-Hon , Yen May-Yung 
Published: April 2021

ABSTRACT
Purpose: To investigate the orbital invasion and metastatic pattern in retinoblastoma, and to analyze the correlation with other pathologic and prognostic factors.
Methods: Pathologic and admission records of 45 patients with a pathologically confirmed diagnosis of retinoblastoma during the past 20 years were reviewed. Clinical risk factors and pathologic findings were analyzed for association with tumor invasion/metastasis using chi-square, Fisher's exact, and Student's t tests.
Results: Clinical risk factors such as exophthalmos, cataract, and pseudohypopyon were significantly correlated with tumor invasion/metastasis. The pathologic finding of choroid involvement was highly predictive of tumor invasion/metastasis. Delayed enucleation (>3 months) also was significantly correlated with tumor invasion/metastasis.
Conclusion: Tumor invasion/metastasis is strongly associated with various ocular, pathologic, and treatment outcome factors. Identification of these risk factors may help plan treatment regimens.
Journal of Pediatric Ophthalmology and Strabismus 2001 ;38:1 66-171.
Iris Neovascularization in Children as a Manifestation of Underlying Medulloepithelioma
Authors: Singh Annapurna , Singh Arun D , Shields Carol L , Shields Jerry A 
Published: April 2021

ABSTRACT
Purpose: To report the occurrence of unilateral iris neovascularization in children secondary to medulloepithelioma.
Methods: Presenting features and the clinical course of patients confirmed to have medulloepithelioma were reviewed.
Results: Seven patients with medulloepithelioma had iris neovascularization during the clinical course. Associated cataract and lens coloboma occurred in two and three cases, respectively. In six (86%) cases, no apparent cause for iris neovascularization could be detected at presentation. Two cases had tube shunts for management of neovascular glaucoma before medulloepithelioma was recognized. All cases eventually required enucleation.
Conclusion: Presence of iris neovascularization is an early manifestation of medulloepithelioma. Children with iris neovascularization of unknown cause should be evaluated to exclude underlying medulloepithelioma.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:224-228.
Clinicopathologic Factors Related to Apoptosis in Retinoblastoma
Authors: Wang An-Guor , Lai Chiung-Ru , Hsu Wen-Ming , Liu Jorn-Hon , Yen May-Yung 
Published: April 2021

ABSTRACT
Purpose: To investigate the presence of apoptosis in retinoblastoma and its correlation with other pathologic and prognostic factors.
Methods: The pathologic and admission records of 25 patients with a pathologically confirmed diagnosis of retinoblastoma were reviewed. TUNEL (TdT dUTP nick end labeling) staining was used to examine apoptosis in the pathologic slides of these 25 patients. The association between apoptosis and clinicopathologic factors was examined with chi-square, Fisher's exact, and Student's t tests.
Results: Of the 25 specimens tested, 11 were TUNEL stain-positive for the presence of apoptotic cells. Apoptosis was found more frequently in younger patients and within rosettes, although these associations were not statistically significant. Apoptosis was not associated with tumor invasion or metastasis.
Conclusion: Apoptotic cells were found in 11 of 25 retinoblastoma specimens. Apoptosis tends to occur in young patients and be distributed within rosettes.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:295-301.
Digital Values for Alpha Acuities
Authors: Arnold Robert W. 
Published: April 2021

Purpose:
The lack of consistent data formatting for visual acuity in electronic medical records has led to inefficient data extraction and analysis.

Methods:
Prior acuity efforts were reviewed and analyzed relative to alpha-designated visual acuity. Prominent electronic medical record formatting was reviewed.

Results:
A table was generated facilitating the assignment of digital values to alpha acuities for metric and United States designation including centered steady maintained for infants and counting fingers, hand motions, light perception, and no light perception for patients with low vision.

Discussion:
Consistent and usable visual acuity data should lead to better research and eventually improve physician burn-out.

[
J Pediatr Ophthalmol Strabismus
. 2021;58(2):132–135.]
Light at the Top: PSYCHIATRIC NURSING STOCKTON STATE HOSPITAL
Authors: Thompson Faith Elise 
Published: April 2021

It is exceedingly difficult to capture on paper tlie schizophrenic. We are accustomed to relating in a structured way, with paragraphs, sentences, and headings. The schizophrenic is unable to put structure to his thoughts. The line between the light of reality and the darkness of fabrication, within his own mind, is only a thin fiber. Words become intensities of light and dark and hot and cold; leaves, chairs and cars become animated. The impossible is no more - life is a cartoon.
The schizophrenic struggles constantly to recognize, accept and function within the limits of reality - this is the light at the top.
Corneal Lathing Using the Excimer Laser and a ComputerControlled Positioning System: Part I-Lathing of Epikeratoplasty Lenticules
Authors: Altmann Johann , Grabner Günther , Husinsky Wolfgang , Mitterer Sabine , Baumgartner Isabella , Skorpik Florian , Asenbauer Talin 
Published: April 2021

ABSTRACT: Precise lathing of epikeratoplasty lenticules is difficult to achieve with the cryolathe due to unpredictable expansion of the lathing tools and the corneal tissue during the freezing process. In addition, the procedure destroys all viable cells in the transplant thereby possibly contributing to the prolonged period of visual rehabilitation. Nonfreezing techniques using the microkeratome or the rotor-trephine, on the other hand, are technically demanding, can cause mechanical damage during cutting or fixation, and, have not given consistently reproducible refractive results.
A new system is presented that allows a variable laser ablation of donor corneas into lenticules for aphakic and myopic epikeratoplasty, as well as for lamellar keratoplasty. With the help of a computer-controlled positioning system that uses high-precision micropositioning elements (both translation and rotational stages) the donor cornea is moved, epithelial side down, in a holding device in front of a focused excimer laser beam (ArF, λ = 193 nm). This photoablation lathing process assures the viability of the stromal cells in the lenticule in close approximation to the treated surface.
The user friendly computer software allows the fast and convenient selection of a variety of parameters, such as the diameter of the optical zone, the shape of the wing zone, the refractive power, the central thickness of the lenticule and the overall contour of the transplant. The first laboratory data of lenticules prepared from human corneas with this "Excimer Laser Corneal Shaping System" are presented. [Refract Corneal Surg 1991;7:377-384.)
Photorefractive Keratectomy With an Argon Fluoride Excimer Laser: A Clinical Study
Authors: Gartry David S , Muir Malcolm G Kerr , Marshall John 
Published: April 2021

ABSTRACT: The results of excimer laser photorefractive keratectomy (PRK) in 16 blind and 120 sighted eyes (136 patients) are presented. Follow up for the blind eyes was 22 months and for the sighted eyes 8 to 18 months (mean, 1 year). A Summit Technology UV200 excimer laser with fluence fixed at 180 mJ/cm
p 2
, beam diameter 4 mm, a frequency of 10 Hz, and ablation rate of 0.22 µ per pulse was used. The range of preoperative myopia was - 1 .50 diopters to - 1 7.50 D (spherical equivalent). Ninety percent of patients undergoing a -2.00 D correction and 75% of patients undergoing a -3.00-diopter correction were within ± 1 .00 D of intended refraction at 6 months. This figure fell to 40% and 20% for the groups undergoing -6.00 D and -7.00 D corrections, respectively. While the trend is toward undercorrection, around 70% of patients in all groups have benefited from a reduction of their myopia by at least half that intended. A variable degree of anterior stromal "haze" was detected in 110 patients (92%) despite a rigid high dose topical corticosteroid regime over 3 months. Best spectacle corrected visual acuity, however, was greater than or equal to preoperative levels in 111 patients (93%). Six patients experienced a reduction of one line of Snellen acuity at 6 months and three of the high myopes lost two lines. No patienfs lost more than two lines of Snellen acuity.

Ninety-four patients (78%) noticed a "halo" around lights at night, more marked in the early postoperative period, which we attribute to the 4-millimeter diameter ablation zone. With a large pupil, both central and paracentral cornea can contribute simultaneously to the retinal image.
We have demonstrated considerable individual variation in response to this surgery, which is more marked in high myopia. Although follow up at the present time is limited, to date PRK appears to be a safe procedure that holds considerable promise for refractive surgery in the future. (Refract Corneal Surg 1991;7:420-435.)
Excimer Laser Phototherapeutic Keratectomy for Shield Ulcers and Corneal Plaques in Vernal Keratoconjunctivitis
Authors: Cameron James A , Antonios Sobhi R , Badr Ihsan A 
Published: April 2021

ABSTRACT
BACKGROUND: Shield-shaped corneal ulcers and corneal plaques in vernal keratoconjunctivitis are associated with delayed epithelial healing, as well as the risks of infectious keratitis and sterile stromal ulceration. Significant visual impairment due to scarring and irregular astigmatism may result from central corneal lesions.
METHODS: Three eyes with central corneal lesions resulting from vernal keratoconjunctivitis were treated by excimer laser after active vernal keratoconjunctivitis was controlled and inflammatory plaque overlying the shield ulcers was removed.
RESULTS: All three eyes showed rapid reepithelialization within 1 week. Spectacle-corrected visual acuity of 20/30 or better was obtained in each eye.
CONCLUSIONS: In selected patients, excimer laser phototherapeutic keratectomy may be a useful adjunct in the treatment of shield-shaped corneal ulcers and plaques in vernal keratoconjunctivitis. [J Refract Surg. 1995;11:31-35.]
Thermal Collateral Damage in Porcine Corneas After Photoablation With Free Electron Laser
Authors: Bende Thomas , Walker R , Jean B 
Published: April 2021

ABSTRACT
BACKGROUND: The study describes a quantitative and systematic investigation of the collateral thermal damage during infrared photoablation as a function of wavelength between 2.7 and 6.7 µm.

METHODS: Using the tunable Free Electron Laser at Vanderbilt University, Nashville, Tenn, 60 freshly removed porcine cadaver eyes were irradiated at wavelengths between 2.7 and 6.7 µm, at a fluence of 1.3 J/cm
p 2
. For wavelengths where no photoablation occurred, fluence was increased to 3.5 J/cm
p 2
; pulse length (macropulse) was 4 µs, consisting of a train of micropulses (pulse duration 2 ps at a 2.9 GHz repetition rate). The corneal buttons were removed and stained with hematoxylin and eosin (H&E) and analyzed by histologic micrometry.

RESULTS: Two thermal damage zones in the remaining tissue were observed: zone 1 showed superficial carbonization and measured between 2 and 4 µm; beyond, the eosinophilic zone 2 measured between 10 and 100 µm. The extent of zone 2 was inversely related to the absorption spectra of the cornea; it was minimal at the 3- and 6-micrometer water absorption bands and maximal at minimal target absorption.
CONCLUSION: The results correlated well with a model of the ablation process. The study provides a systematic and predictive element for the determination of collateral thermal adverse effects; it does not yet include pulse length variation as a determining factor. [J Refract Surg. 1995;11:129-136.]
Excimer Laser In Situ Keratomileusis
Authors: Kremer Frederic B , Dufek Michael 
Published: April 2021

ABSTRACT
We have been using a 193-nm excimer laser under protocol to ablate the corneal stromal bed after creating a hinged corneal flap with a microkeratome in order to reduce or eliminate refractive error. Thirty-one consecutive eyes are reviewed with a preoperative mean spherical equivalent refraction of -6.25 diopters (D) (range -3.50 to -11.75 D). Preoperative mean astigmatism was +0.87 D (range +0.25 to +2.75 D). At 6 months postoperatively, the mean spherical equivalent refraction was -0.50 D (range -3.50 to +2.00 D). Mean postoperative astigmatism was 0.64 D (range 0.25 to 3.50 D). A result within 1.00 D of attempted correction was achieved in 74.2% of eyes. Uncorrected visual acuity after a single procedure was 20/40 or better in 81% of eyes. Spectacle corrected visual acuity was unchanged in 26 (84%), decreased 1/2 line in 2 (6%), and increased 2 lines in 1 (3%). The incidence of postoperative complications was minimal. Excimer laser ablation in the stromal bed in combination with a hinged corneal flap seems to offer many advantages over excimer laser surface ablation with fewer complications. [J Refract Surg. 1995;11(suppl.):S244-S247.]