bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Term Strabismus Complications Following Retinal Detachment Surgery
Authors: Muñoz Michelle , Rosenbaum Arthur L 
Published: April 2021

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

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

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

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

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

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

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

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

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

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

ABSTRACT
We have observed congenital glaucoma in a patient with a skeletal dysplasia closely resembling Kniest syndrome. The clinical and radiographic features, along with the differential diagnosis of Kniest syndrome, are discussed. Review of the literature suggests a relationship between the pathophysiology of bone dysplasia and congenital glaucoma. Congenital glaucoma may be an additional ocular finding in Kniest syndrome.
The Value of Flash Visual Evoked Potentials in Albinism
Authors: Fitzgerald Kathleen , Cibis Gerhard W 
Published: April 2021

ABSTRACT
In albinism, the majority of temporal retinal fibers serving the nasal visual field cross at the chiasm and project to the contralateral hemisphere. This misrouting is seen in hemispheric asymmetries present in the visual evoked potential (VEP). Misrouting of retinal fibers was also thought to occur in dissociated vertical deviation, Prader-Willi syndrome, and perhaps carrier states of albinism. However, recent literature is reaching the conclusion we have drawn in our laboratory: only albinism shows VEP hemispheric asymmetries that reverse when the other eye is stimulated. Use of different stimuli, recording conditions, and response criteria among investigators has created some confusion in differentiating what constitutes asymmetry. We conclude that use of a diffuse flash stimulus and a bipolar electrode derivation that compares differences between the left and right occipital hemispheres will clearly differentiate albinism from all other conditions, making it especially useful in a pediatric population.
Congenital Ocular Defects Associated With an Abnormality of the Human Chromosome 1: Trisomy 1q32-qter
Authors: Clark B J , Lowther G W , Lee W R 
Published: April 2021

ABSTRACT
This article describes the detailed ocular pathology found in a premature neonate, born at 34 weeks, with multiple congenital anomalies resulting from de novo trisomy 1q32-qter. The ocular defects include goniodysgenesis, persistent tunica vasculosa lentis and hyaloid vessels, hypopigmentation of the posterior iris epithelium, ectopia of the ciliary processes, and abnormal insertion of the ciliary muscle and cataract. This is the first report of the detailed ocular pathology in a case of trisomy 1q and is also unusual in that the chromosomal defect has apparently arisen de novo in the proband.
Plaque Radiotherapy for Residual or Recurrent Retinoblastoma in 91 Cases
Authors: Shields Jerry A , Shields Carol L , De Potter Patrick , Hernandez J Carlos , Brady Luther W 
Published: April 2021

ABSTRACT
Plaque radiotherapy has been used successfully as primary treatment for selected solitary retinoblastomas. However, there is relatively little information on its role as a secondary treatment after other methods have failed to control the tumor. We have used solitary plaque radiotherapy to treat 91 children with residual or recurrent retinoblastoma after failure of one or more treatment modalities, which included external beam radiotherapy in 63 children, plaque radiotherapy in 9, cryotherapy in 26, and photocoagulation in 18, for a total of 116 treatments in the 91 children. Despite the fact that enucleatlon was considered to be the only remaining option in many of these children, tumor regression was achieved in 81 cases (89%) and recurrence developed in only 10 cases (11%) during a mean follow up of 52 months. Treatment of the recurrence following plaque radiotherapy in these 10 cases included repeat plaque radiotherapy in 6 cases, enucleation in 3 cases, and external beam radiotherapy in 1 case. In view of the fact that enucleation was being considered as the only remaining option in many of these children, control of the tumor with plaque radiotherapy in 89% of the cases is very encouraging. Plaque radiotherapy should be considered as an important option for recurrent retinoblastoma after failure of other methods to achieve tumor control.
Factors Affecting Treatment Compliance in Amblyopia
Authors: Smith Lucy K , Thompson John R , Woodruff Geoffrey , Hiscox Fiona 
Published: April 2021

ABSTRACT
Amblyopia is the most common form of visual disability in children. Successful treatment by patching depends on compliance, but evidence of factors affecting compliance is limited and contradictory. Because there is a well established relationship between social deprivation and access to health care, we hypothesized that social deprivation might be associated with noncompliance. Data from a historical cohort of 961 children from seven English orthoptic clinics starting treatment for amblyopia in 1983 were used to study factors affecting compliance with amblyopia treatment. Children were classified as noncompliant if they failed to attend all appointments prescribed during the first year of treatment. There was a significant difference in compliance between centers (P=.0001). Overall, children with anisometropic amblyopia were more compliant than those with strabismus but this varied significantly between centers. A relationship between social deprivation and compliance was also found (P=.00001). Only 41% of children from the most deprived wards were compliant compared with 61% in the least deprived wards. Compliance was not found to be related to age at starting treatment.
Unilateral Surgery for Exotropia With Convergence Weakness
Authors: Kraft Stephen P , Levin Alex V , Enzenauer Robert W 
Published: April 2021

ABSTRACT
We prospectively studied 14 patients whom we treated surgically for exotropia (XT) with convergence weakness measuring at least 8 Δ for distance (6 m) that increased at least 8 Δ at near (Yi m). Surgery involved lateral rectus recessions and medial rectus strengthenings (advancements or resections) to eliminate distance and near deviations and simultaneously collapse near-distance differences. The medial rectus was strengthened more than the lateral rectus was recessed; amounts were based on the near deviation. Minimum follow-up was 6 months after surgery. Preoperatively, the mean XT at distance was 18.3 Δ (range, 8 to 35 Δ) and at near 30.1 Δ (range, 16 to 50 Δ). At latest follow-up evaluations the mean distance deviation was 0.1 Δ XT and at near 1.8 Δ XT. The near-distance differences were reduced by a mean of 10.2 Δ; the mean postoperative difference was 1.7 Δ. Unilateral surgery for XT with convergence weakness biased to medial rectus strengthening and geared to near deviation can successfully collapse the neardistance differences while satisfactorily aligning both distance and near fixation. This surgery has low risk of creating long-term postoperative esodeviations at distance.
Haptic Breakage Following Neonatal IOL Implantation in a Nonhuman Primate Model
Authors: Lambert Scott R , Fernandes Alcides , Grossniklaus Hans E 
Published: April 2021

ABSTRACT
To evaluate the long-term safety of implanting intraocular lenses (IOLs) in neonatal eyes using a nonhuman primate model, a one-piece all-polymethylmethacrylate (PMMA) IOL was implanted into the posterior chamber of 21 neonatal Rhesus monkey eyes following a lensectomy and anterior vitrectomy. These monkeys then were monitored for 26 to 40 months for complications. The eyes from seven monkeys were studied histopathologically. One or both haptics broke on 7 of the 21 (33%) IOLs in a mean of 21 months (range 6 to 31 months) after their implantation. Only one of the haptics from these seven eyes was found to be in the capsular bag when these eyes were studied histopathologically. Nine haptics had eroded into the iris leaflets, two into the ciliary body, and one into the anterior chamber. One additional haptic was in the sulcus. The haptics of one-piece all-PMMA IOLs may break if implanted in neonatal eyes. A number of factors likely contributed to haptic breakage in these eyes, including an increased number of reoperations, malpositioning of IOL haptics, rapid circumferential and axial growth, and the formation of large Soemmerring's rings.
On Infantile Esotropia With Nystagmus in Abduction
Authors: Ciancia Alberto O 
Published: April 2021

ABSTRACT
Infantile esotropia with nystagmus in abduction is characterized by early onset, jerk nystagmus in abduction, and dissociated vertical deviation, among other features. Electro-oculographic tracings present easily recognizable patterns both in saccadic and pursuit movements. Visual evoked responses are asymmetric in most cases and optokinetic nystagmus is invariably asymmetric. Visual cortex maldevelopment seems to play a major pathogenic role. Recent findings in myelomeningocele and in patients with posterior fossa tumors suggest that pathological alterations in this area may tend to induce similar anomalies in electro-oculographic and optokinetic nystagmus recordings. Posterior fossa damage or impairment is therefore suspected to be a possible causative factor in the development of infantile esotropia with nystagmus in abduction.
Strabismus Associated With Meningomyelocele
Authors: Biglan Albert W 
Published: April 2021

ABSTRACT
Introduction: Strabismus occurs frequently in patients with spina bifida or meningomyelocele.
Patients and Methods: I performed 1544 eye examinations in 298 patients with spina bifida over a period of 15 years. The patient records were retrospectively reviewed for visual acuity, binocular function, and strabismus. Select patients with A-pattern strabismus were recalled for neuroimaging.
Results: Visual acuity was correctable to 20/40 in 85% of the patients. One hundred and eighty-three patients (61%) had strabismus at some time over the study period. Sixtythree percent had an esodeviation; 37% an exodeviation. A-pattern strabismus was more common in patients with exotropia (39%) than in those with esotropia (27%). Defects on neuroimaging in the region of the vertical gaze pathways in the brain stem were correlated with A-pattern strabismus.
Conclusion: With increased longevity of the patient with spina bifida, quality-of-life issues become increasingly important. Amblyopia, strabismus, and other acquired defects in the visual system related to hydrocephalus should be closely monitored and treated when indicated.
Early and Late Postoperative Alignment Following Unilateral Lateral Rectus Recession for Intermittent Exotropia
Authors: Olitsky Scott E 
Published: April 2021

ABSTRACT
Purpose: Bilateral lateral rectus recession is useful in the treatment of intermittent exotropia. A unilateral recession may be used in the treatment of small-tomoderate angle intermittent exotropia as well. An early overcorrection following bilateral surgery has been shown to carry the best prognosis for future alignment. The relationship between the early and late postoperative alignment following unilateral surgery is unknown. The current study was designed to establish this relationship.
Methods:Thirty-seven patients undergoing a unilateral lateral rectus recession for intermittent exotropia were prospectively evaluated to determine the relationship between early and late postoperative alignment. Patients were evaluated 1 week and 6 months following surgery. A satisfactory result was considered to be alignment within 8 prism diopters (Δ).
Results: Of the 37 patients who underwent surgery, 35 completed the study. Overall, 77% of patients achieved a satisfactory result at the 6-month exam (27/35). Satisfactory alignment at 6 months was obtained in all patients who were Orthophorie (14/14), 77% (10/13) of patients with an exodeviation less than 9 ? (10/13), and 60% (3/5) of patients with an esodeviation less than 9 ? at the 1-week postoperative exam. Twenty-nine percent of patients changed alignment status during this time period (10/35), and 29% of all patients became more divergent (10/35). The average divergent shift for the entire group was 1.6 Δ and was not significant. Among those patients who experienced a divergent shift, the average amount was 6 Δ.
Conclusions: There is not a significant difference in early versus late alignment following unilateral lateral rectus recession. Surgeons performing this procedure should not expect a significant divergent shift from the first postoperative week. Unlike bilateral recessions where an early overcorrection is desirable, acceptable alignment in the first week following surgery carries the best prognosis for later alignment.
Screening for Suppression in Young Children: the Polaroid Suppression Test
Authors: Pott Jan Willem R , Oosterveen Douwe K , Duin Jackie Van Hof-van 
Published: April 2021

ABSTRACT
Background: Assessment of monocular visual impairment during screening of young children is often hampered by lack of cooperation. Because strabismus, amblyopia, or anisometropia may lead to monocular suppression during binocular viewing conditions, a test was developed to screen for suppression in young children.
Methods: Children were invited to look through two polaroid filters of different polarization direction at two pictures covered with polaroid filters of opposite polarization direction. In this way, each eye could only see one of the two pictures. In cases of suppression, only one picture would be visible. Acuity measurements in 201 5-year-old children were compared with the Polaroid Suppresion test (PST) results.
Results:The PST had a high success rate (99.5%) and testing time was under 1 minute. Specificity of the PST for acuity impairments was 91%. The low sensitivity of 60% was caused mainly by the fact that some children with binocular acuity impairments were not detected with the PST. However, the PST was highly sensitive for significant interocular acuity differences.
Conclusion: The PST has been found to be a useful screening method for amblyogenic factors in young children. The test can be carried out without occlusion of one eye. The apparatus is portable, the test duration is short, and the costs are low. The results indicate that the PST is a very promising tool to use in clinical conditions and for screening large numbers of young children.
Early-Onset Accommodative Esotropia
Authors: Havertape Susan A , Whitfill Charles R , Cruz Oscar A 
Published: April 2021

ABSTRACT
Purpose: To determine the frequency of accommodative esotropia with onset by 6 months of age; to determine if the presence or absence of characteristics usually associated with infantile esotropia can help in the diagnosis; and to determine if antiaccommodative therapy is adequate treatment for the esotropia.
Methods: The charts of 100 patients with infantile esotropia, seen over a 2-year period (September 1995 to September 1997), were reviewed. We identified those with at least 2.25 diopters (D) of hyperopia and determined the presence of large angle esotropia (>30 to 40 prism diopters [δ]), amblyopia, inferior oblique overaction, dissociated vertical deviation, latent nystagmus, and cross-fixation. The success of antiaccommodative therapy, if attempted, was also evaluated.
Results: Of 100 patients with infantile esotropia, 15 (15%) were found to have at least +2.25 D. This represented 8% of all patients with accommodative esotropia seen over the same time period. The average age at initial examination was 21 months, although the reported age of onset in all cases was 6 months or less. Two had surgery before presenting to our institute. Eleven of 13 (84%) had 40 Δ or less. Six (40%) of the 15 had amblyopia, 5 (33%) had inferior oblique overaction, 3 (20%) had dissociated vertical deviation, 1 (7%) had latent nystagmus, and 4 (27%) had cross-fixation. Of the 13, 7 were given glasses initially, with 3 being fully corrected. Six were not given glasses, all had surgery, and all were given glasses postoperatively for a residual esotropia.
Conclusion: Fifteen percent of infantile esotropia patients and 8% of accommodative esotropia patients have infantile accommodative esotropia. Other characteristics of infantile esotropia may be present, but are less frequent, and at least 40% are fully corrected with spectacles indicating that when the hyperopia is 2.25 D or greater, antiaccommodative therapy should be instituted before surgery.
Journal of Pediatrce Ophthalmology & Strabismus 1999;36:69-73.