bluuebunny/crossref_metadata_2025_split huggingface dataset:
Congenital Eyelid Eversion With Orbicularis Spasm
Authors: Raab Edward L , Saphir Richard L 
Published: April 2021

ABSTRACT
Eversion of the lids at birth is a rare condition of debated etiology. It has been attributed most frequently to birth trauma or to congenital lid hypotonia. Most reported cases have been treated by immediate taping of the lids or by surgery (tarsorraphy, intermarginal sutures, and/or plastic procedures). A prominent association with Down's syndrome has been noted. We report a normal infant, born by Caesarean section, with bilateral upper eyelid eversion which subsided spontaneously after treatment only with lubricants. A prominent spastic ectropion component was observed. Lid laxity appeared to be an effect rather than a cause of the eversion, and disappeared as the condition improved. Management should take into account the duration of total occlusion caused by this abnormality.
Abolition of Feeding Intolerance Following Ophthalmologic Examination of Neonates
Authors: Hermansen Marcus C , Hasan Shirin 
Published: April 2021

ABSTRACT
Administration of mydriatic medication and ophthalmologic examination have previously been associated with feeding intolerance, characterized by large retained gastric aspirates and abdominal distention. In an attempt to eliminate this problem, we instituted a policy of withholding feedings for four hours following ophthalmologic examination. A prospective series of 50 consecutive patients was then followed to determine the incidence of feeding intolerance 24 hours prior to and 24 hours following the examination. All infants had received cyclopentolate hydrochloride and phenylephrine hydrochloride prior to the examination. A critical review of the nursing notes revealed no increased incidence in feeding intolerance during the 24-hour period following examination. There were no cases of necrotizing enterocolitis during either period. This study provides evidence that the incidence of feeding intolerance following ophthalmologic examinations might be reduced by withholding feeding for four hours after the examinations.
Spontaneous Corneal Perforation and Extrusion of Intraocular Contents in Premature Infants
Authors: Bachynski Brian N , Andreu Roberto , Flynn John R 
Published: April 2021

ABSTRACT
Unilateral spontaneous corneal perforation with expulsion of intraocular contents is reported in two very small, high risk premature neonates. The one surviving infant demonstrated unilateral microphthalmos with aphakia and a small leukoma. The cause of this phenomenon is not clear, and measures which might be taken to prevent its occurrence are not obvious.
Binocular Polaroid Test
Authors: Nuzzi Giuseppe 
Published: April 2021

ABSTRACT
A test is presented for the detection of small suppression scotomas in strabismic and in anisometropic patients. Three small light-spots (the central is polarized) are viewed through Polaroid filters placed in front of the eyes. This arrangement produces the perception of the central spot only from one eye, but normal fusion provides the perception of three light-spots. Complete suppression of the central light indicates the presence of a scotoma in the binocular visual field. An inhibition scotoma in the nondominant eye was found in all cases of small angle esotropia and of anisometropic amblyopia.
Infantile Esotropia: Results in the Neurologic Impaired and "Normal" Child at NCMH (Six Years)/DISCUSSION
Authors: Holman Ronald E , Merritt John C , Biglan Albert W 
Published: April 2021

ABSTRACT
Charts of all infantile esotropes who received their primary surgical procedure at the North Carolina Memorial Hospital, between February 1978 and June 1984 were reviewed. Neurologic problems (general and ocular) were identified in 29 of the 47 patients (61.7%) followed a minimum three months (x = 25.0 ± 2.9 mos). Frequent general neurologic problems were prematurity, hydrocephalus, mental retardation, cerebral palsy, meningomyelocele, intraventricular hemorrhage, and seizures (neonatal and/or postnatal). Abducens nerve palsy was the most common ocular neurologic impairment. Neurologic impaired esotropes were older (x = 31.9 ± 3.8 mos) than the "normal" group (x = 17.0 ± 3.3 mos) at the time of surgery. Recession/resection procedures were performed on 13 (44.8%) of the neurologically impaired and nine (50.0%) of the normal esotropes. Bimedial recessions were employed on 12 (41.4%) of the patients with neurologic problems and seven (38.8%) of the normal esotropes. Unilateral medial recessions and/or inferior oblique recessions were performed on six patients. At last follow-up, orthophoria (± 10Δ) was present in 16 (55.2%) neurologically impaired patients and 15 (83.3%) normal esotropes (p<0.05 by the normal deviate (z) test). Seven (24.1%) neurologically impaired patients had residual esotropia, while consecutive exotropia was present in six (20.7%) patients. Among normal esotropes, residual esotropia was found in one patient and consecutive exotropia in two (11.1%) patients. DVD's occurred in nine patients while four subjects developed a postoperative accommodative component.
Reliability and Variability in the Measurement of Interlimbal Distance With a Semiautomated Video Replay Analysis System (SAVRAS)
Authors: Lingua Robert W , Azen Stanley P , Doiron Dan , Egge Alan , Levin Lori , Emry Jeanne Kordic , Baker Sherryl 
Published: April 2021

ABSTRACT
This paper reports on the reliability and variability of a semi-automated, video replay and analysis system (SAVRAS) in determining interlimbal distance in patients with strabismus. Factors under investigation were: choice of observer, choice of video frame, patient age and patient state (awake or anesthetized). It was demonstrated that SAVRAS was a highly reliable and reproducible system. This system is currently in use to evaluate the relationship between the succinylcholine induced ocular position, under anesthesia, and the postoperative awake alignment.
Intraocular Pressure Variation During Strabismus Surgery
Authors: Pe'er Jacob , Drenger Benjamin , BenEzra David 
Published: April 2021

ABSTRACT
The changes in IOP during strabismus surgery were studied in 40 patients. In most, 37 eyes, there was a marked decrease of IOP during surgery and rapid return to initial levels of IOP. In 13 out of 14 eyes that underwent bilateral surgery, the IOP in the first operated eye returned to about baseline levels by the end of surgery on the second eye. No correlation was found between the changes in IOP and: the type of surgery, the operated muscles, the duration of surgery and anesthesia, or the patients' age. We surmise that the decrease of IOP is probably associated with the intensity of the massage of the globe during the surgery.
Unusual Variant of Familial Aniridia
Authors: Hamming Nancy A , Miller Marilyn T , Rabb Maurice 
Published: April 2021

ABSTRACT
A woman and her two children had apparent dominantly inherited ocular abnormalities including aniridia, ptosis, nystagmus, corneal pannus, persistent pupillary membrane, lenticular opacities, and foveal hypoplasia.
A broad spectrum of iris abnormalities was observed: the daughter had aniridia with persistent pupillary membrane strands traversing the anterior lens capsule; the iris of the mother and son had a velvety surface with no detailed crypts, but did have some persistent pupillary membrane tags extending from the collarette. All three family members had moderately severe bilateral ptosis, pendular nystagmus, corneal pannus, and visual acuity of 20/200.
Several systemic abnormalities also were noted, including obesity and mental retardation in the two children, and alopecia, cardiac abnormalities, and frequent spontaneous abortion in the mother. Family history indicated that the children's maternal grandmother also had similar ocular findings.
We believe that this constellation of findings represents a rare, apparently dominant, variant of aniridia.
Adjustable Suture Strabismus Surgery
Authors: Keech Ronald V , Scott William E , Christensen Laurie E 
Published: April 2021

ABSTRACT
We examined 333 patients between the ages of 11 and 70 years who underwent strabismus surgery with adjustable sutures over a ten-year period. The type of strabismus, the number and amount of adjustments, the postoperative drift, and complications were evaluated. A large percentage of patients required adjustment to obtain the desired postoperative position. The postoperative drift patterns were characteristic for each type of preoperative deviation and were similar to that reported for nonadjustable procedures. Adjustable suture techniques were especially helpful in selected horizontal deviations, vertical deviations, and the more complex strabismus problems. The complications from adjustable suture operations in this series were minimal.
Myelinated Nerve Fibers, Axial Myopia, and Refractory Amblyopia: An Organic Disease
Authors: Ellis George S , Frey Thomas , Gouterman Randi Z 
Published: April 2021

ABSTRACT
Six patients with the syndrome of myelinated nerve fibers, high axial myopia, and refractory amblyopia were studied with particular emphasis on their sensory status. Ocular examination included keratometry, B-scan ultrasonography, measurement of axial lengths, and fundus photography. Sensory testing included visual fields, photostress testing, and neutral density filter visual acuities. Electrophysiological testing was also performed on some patients. Our findings suggest an organic etiology for the poor vision, although all patients had superimposed functional amblyopia as well. We suggest that myelination about the macula is the most likely cause of this poor vision and that the myelination, in some way, may have stimulated the development of the high myopia.
Adie's Syndrome as a Cause of Amblyopia
Authors: Agbeja A M , Dutton G N 
Published: April 2021

ABSTRACT
Adie's syndrome comprises a tonic pupil, which may be associated with impairment of accommodation, in the presence of diminished or absent deep tendon reflexes. We report a case of a 4-year-old boy with Adie's syndrome in which latent hypermetropia was made manifest by accommodative paresis and resulted in reversible amblyopia.
Congenital Absence of the Superior Rectus Muscle: A Case Report
Authors: Mather Thomas R , Saunders Richard A 
Published: April 2021

ABSTRACT
We report a case of bilaterally absent superior rectus muscles presenting clinically as a double elevator palsy. This patient is unique due to paradoxical ocular movements on attempted upgaze and the absence of other major craniofacial anomalies. Successful surgical correction was accomplished using a modified Jensen procedure where the superior halves of the horizontal rectus muscles were united using synthetic absorbable sutures. Congenital absence of the superior rectus muscles should be suspected in patients with severe elevation deficiency associated with paradoxical ocular movements.
Thyroid Eye Disease Presenting After Cataract Surgery
Authors: Hamed Latif M , Lingua Robert W 
Published: April 2021

ABSTRACT
Strabismus presenting after cataract surgery has been attributed to a variety of disorders, some of which are unrelated to the surgery. When thorough ophthalmologic and neurologic examinations fail to elucidate a definitive etiology, the motility disturbance is often ascribed to operative trauma to the orbital soft tissues. In a series of 58 patients with strabismus presenting after cataract surgery, eight (14%) were found to have previously unsuspected thyroid eye disease. Three of the eight patients had past histories of systemic dysthyroidism, but none reported diplopia prior to cataract extraction. Three of the remaining five patients showed normal thyroid function tests. Absence of diplopia prior to cataract extraction in these patients may be due to: 1) poor vision precluding diplopia until surgical restoration of sight; 2) intraoperative aggravation of the inflammatory process in otherwise subclinical thyroid eye disease; or 3) onset of clinical thyroid eye disease that was temporally associated with cataract surgery by chance. Thyroid eye disease should be included in the differential diagnosis of all patients presenting with binocular diplopia following cataract surgery. Suitable neuroimaging studies may be needed to confirm the diagnosis.
Idiopathic Superior Oblique Palsies in Children
Authors: Robb Richard M 
Published: April 2021

ABSTRACT
The records of 110 patients with superior oblique palsy seen at the Boston Children's Hospital between 1966 and 1988 were reviewed. Patients with identifiable orbital or neurological disorders affecting the fourth cranial nerve or with a history of head trauma preceding their superior oblique palsy were excluded from analysis. Patients were also excluded because of prior surgery elsewhere or insufficient diagnostic information. The remaining 63 patients were considered to have idiopathic superior oblique palsies. All 63 patients presented with unilateral palsies. All had incomitant hypertropia of the affected eye, greater on gaze to the contralateral side and increased by ipsilateral head tilt. Left eyes were affected in 41 patients. The age at first ophthalmological examination was spread over the first 20 years, with heavier representation in the first 5 years and decreasing numbers in each succeeding 5-year interval. Only one patient was found to have a masked bilateral superior oblique palsy following surgery for an apparent unilateral palsy. A distinction is made between unmasking a bilateral superior oblique palsy and surgical overcorrection of a unilateral palsy. The predominant unilaterality of idiopathic superior oblique palsies is in contrast to the reported frequency of bilaterality in traumatic cases.
Nodular Fasciitis Presenting as a Rapidly Enlarging Episcleral Mass in a 3-Year-Old
Authors: Holds John B , Mamalis Nick , Anderson Richard L 
Published: April 2021

ABSTRACT
A rapidly enlarging periocular mass in a child obligates the treating physician to rule out a malignancy, especially a rhabdomyosarcoma. A 3-year-old girl presented with a 5-day history of a rapidly growing episcleral mass superonasal to the globe, adjacent to the superior rectus muscle insertion. The lesion was locally excised. A sarcoma could not be excluded on frozen sections. Permanent sections and electron microscopy revealed nodular fasciitis, a benign lesion with a pseudosarcomatous histologic appearance. No recurrence has been noted at 9 months follow-up. Nodular fasciitis is a benign proliferation which should be considered in the differential diagnosis of a rapidly enlarging subconjunctival or orbital mass in a child.
Stereoacuity Testing in the Monofixation Syndrome
Authors: Clarke William N , Noel L P 
Published: April 2021

ABSTRACT
A group of patients with the monofixation syndrome were assessed prospectively to compare performance on Titmus and Randot stereograms under monocular and binocular conditions. These patients achieved monofixation either as a result of surgery for infantile esotropia, or because of a partially accommodative esotropia or significant anisometropia. Their ability to detect elevation of the Titmus circles was not significantly better with two eyes as compared to that level achieved using only their monofixating eye. However, performance on the Titmus animals and on Randot circles or animals showed better discrimination. These data would suggest that the monocular clues available in determining elevation of the Titmus circles would invalidate establishing a diagnosis of monofixation.
Vertical Rectus Muscle Transposition Surgery for Duane's Syndrome
Authors: Molarte Althea B , Rosenbaum Arthur L 
Published: April 2021

ABSTRACT
Thirteen patients with Duane's syndrome, Type I, underwent full vertical rectus muscle transposition. Prior to surgery, all patients had esotropia in the primary position and 11 patients had a face turn. Postoperatively, esotropia was improved in 77%. The face turn was improved in 100% and eliminated in 69%. Abduction ability was increased and binocular diplopia-free field size enlarged to a mean of 60°. Seven patients (54%) with a mean preoperative deviation of 17 prism diopters required only vertical rectus muscle transposition to improve their face turn and strabismus. Six patients (46%) with a mean preoperative deviation of 30 Δ required an additional medial rectus recession several months later. Two patients (15%) developed a vertical deviation following vertical rectus muscle transposition.
Preoperative Alternate Occlusion Decreases Motion Processing Abnormalities in Infantile Esotropia
Authors: Jampolsky Arthur , Norcia Anthony M , Hamer Russell B 
Published: April 2021

ABSTRACT
We have examined the effects of preoperative, full-time alternate occlusion on the development of visual motion processing mechanisms. Motion visual evoked potentials (MVEPs) were recorded longitudinally in 14 infantile esotropia patients during the course of standard preoperative occlusion therapy. The MVEP in these patients was initially asymmetric in a fashion consistent with a nasalward/temporalward response bias, with a motion asymmetry significantly higher than that of agematched normals. The magnitude of the developmental motion asymmetry declined significantly after an average of 24 weeks of alternate occlusion. This result implies that the binocular motion-sensitive cells underlying the MVEP retain some degree of plasticity up to at least 1 year of age. Our data suggest further that the persistence of motion asymmetries in untreated infantile esotropia patients is maintained by an active process that can be disrupted by alternate occlusion. Alternate occlusion apparently eliminates a form of abnormal binocular interaction that supports the persistence of the motion asymmetry. We propose that one of the necessary pre-conditions for symmetricization of motion processing in infantile esotropia is the absence of abnormal competitive binocular interactions.
Change of Eye Muscle Sarcomeres According to Eye Position
Authors: Scott Alan B 
Published: April 2021

ABSTRACT
In three monkeys, the right eye was moved from the primary position to a position of 30° to 45° exotropia by suturing the globe to the orbital wall. In two animals perfused immediately following suturing, histological examination showed the medial rectus and its sarcomeres to be lengthened and the lateral rectus and its sarcomeres to be shortened as compared to those of the unoperated control eye. In the third monkey, after exotropia was maintained for 2 months, the muscle lengths changed but the sarcomere lengths were similar to those of the control eye. We interpret this to indicate addition of sarcomeres to the lengthened medial rectus and removal of sarcomeres from the shortened lateral rectus. This adaptation to conform muscle length to eye position may explain the altered eye position which persists following periods of eye deviation due to muscle paralysis, prior surgery, injury, or botulinum toxin treatment.
Observations on Bilateral Simultaneous Botulinum Toxin Injection in Infantile Esotropia
Authors: McNeer Keith W , Spencer R F , Tucker Mary G 
Published: April 2021

ABSTRACT
Botulinum toxin (BoTX) is an effective pharmacological alternative to the surgical management of strabismus in adults. In a previous study, we found that concurrent bilateral medial rectus muscle BoTX injections for infantile esotropia could produce stable ocular realignment without significant risk. No other investigators have used bilateral simultaneous BoTX injection. We report the results of bilateral simultaneous medial rectus BoTX injection in 57 infantile esotropia patients followed for a minimum of 12 months. The esotropic angle in 27 infantile esotropia patients under 12 months of age was reduced from 43 ± 12 to 1 ± 2 prism diopters. The esotropic angle in 30 infantile esotropia patients at a mean age of 24 months was reduced from 31 ± 12 to 2 ± 3 Δ. Other variables including late onset of hyperopic refractive errors, dissociated vertical deviations, overacting oblique muscles, and consecutive exodeviations are evaluated. We regard BoTX as reliable therapy in infantile esotropia.
A Comparison of Surgical Techniques for the Treatment of Acquired Esotropia With Increased Accommodative Convergence/ Accommodation Ratio
Authors: West Constance E , Repka Michael X 
Published: April 2021

ABSTRACT
The conventional surgical treatment for acquired esotro pia with increased accommodative convergence/ accommodation ratio consists of bilateral medial rectus recessions of graded amounts based on the distance deviation while wearing full hyperopic correction. This retrospective study was undertaken to determine whether surgery was more successful when performed for the distance or near deviation measured through the distance correction. Surgical success was evaluated by 1) long-term motor alignment of ≤ 10 prism diopters of esoor exotropia at distance and near, 2) sensory fusion as determined by Worth 4-Dot at 33 cm and Randot II stereo acuity testing, and 3) the continued need for bifocal or spectacle correction.
Nine patients underwent surgery for their distance deviation measured with full hyperopic correction; all (100%) were successful by alignment and eight of nine (89%) by sensory criteria. Twenty-five patients underwent surgery enhanced by 1.0 to 6.5 mm per eye over the dose of surgery for the distance angle (average 3.1 mm); 20 of 25 (80%) were successful by alignment criteria and 21 of 25 (84%) were successful by sensory criteria. Two of nine patients (22%) in the distance target angle group and 13 of 25 patients (52%) in the near target angle group were able to discontinue spectacles and maintain satisfactory alignment. Six of nine (67%) patients in the distance angle group were able to discontinue bifocals, while every patient in the near angle group was so benefited. No patient in the distance target angle group, but two patients in the near target angle group, required a second operation.
The near angle measured through the distance correction may be used to determine the target angle for acquired esotropia surgery. Use of this angle reduces the need for continued spectacle use, but with a risk of overcorrection.
SKILL Card Results in Amblyopic Children
Authors: Leguire Lawrence E , Suh Steven , Rogers Gary L , Bremer Don L 
Published: April 2021

ABSTRACT
Two experiments were undertaken to assess high contrast-high luminance (HCHL) and low contrast-tow luminance (LCLL) visual acuity as measured with the Smith-Kettlewell Institute Low Luminance (SKILL) card, in childhood amblyopia. In experiment 1, HCHL and LCLL visual acuity was measured in 11 amblyopic children and in 12 normal children of similar age. The results revealed that HCHL visual acuity was similar in the normal eyes and in the amblyopes' dominant eyes, and was abnormal in 91% of the amblyopic eyes. LCLL visual acuity was significantly worse in normal eyes compared to the amblyopes' dominant eyes, and was abnormal in only 64% of the amblyopic eyes. In experiment 2, HCHL and LCLL visual acuity was measured in seven previously tested amblyopic children, after a 5-month interval, and in six additional amblyopic children. In the amblyopic children who were tested twice, significant test-retest reliability for HCHL and LCLL visual acuity was found and visual acuity varied by 3.6%. The results of experiment 2 corroborated the results of experiment 1 from the amblyopic children. It is concluded that visual acuity in the amblyopic eye tends to normalize under low contrast-low luminance conditions. In addition, the mechanism(s) underlying amblyopia appear also to influence the dominant eye, resulting in superior visual acuity under low contrast-low luminance conditions.