bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinoblastoma: Correlation Between Age at Diagnosis and Survival
Authors: Abramson David H , Ellsworth Robert M , Grumbach Nicholas , Sturgis-Buckhout Lee , Haik Barrett G 
Published: April 2021

ABSTRACT
Life tables analyses were performed from the records of 1147 patients seen between 1958 and 1983 to determine correlation between age at diagnosis and survival from metastatic retinoblastoma. No difference was noted overall in survival from metastatic retinoblastoma for unilateral vs. bilateral, male vs female, or family history vs negative family history. Survival rate of 21 of 40 patients diagnosed after age 7 and receiving no treatment was 96%. Two patients in this group did develop metastasis: one because of late diagnosis and one because treatment was refused. One patient with an "arrested retinoblastoma" showed growth in his third decade, necessitating treatment.
Survival was poorest in patients diagnosed between ages two and seven years where mortality was 19% from metastatic retinoblastoma. Patients diagnosed between birth and two years had an intermediate survival of 95%. Because of second nonocular tumors, survival of the patient with unilateral retinoblastoma was significantly better than that of the bilaterally affected child.
Up- and Downshoot in Duane's Retraction Syndrome
Authors: von Noorden Gunter K , Murray Elizabeth 
Published: April 2021

ABSTRACT
Up- and downshoot of the adducted eye in patients with Duane's retraction syndrome was surgically eliminated in five patients by posterior fixation of the horizontal rectus muscles. Retroequatorial fixation of these muscles reduces sideslip and thus a vertical effect of the co-contracting horizontal rectus muscles.
Treatment of Facial Spasm With Oculinum (C. Botulinum Toxin)
Authors: Biglan Albert W , May Mark 
Published: April 2021

ABSTRACT
Forty-six consecutive adult patients with facial spasm were treated with one or more Botulinum toxin (Oculinum) injections to control muscle spasm. During the follow-up period of 6.6 months (one week-12 months), 27 patients required retreatment with a mean time interval of 3.4 months between treatments. Control of facial spasm was achieved in all patients. Complications included occasional bruising around the injection site and a transient blepharoptosis in one patient. No systemic effect was observed. This preliminary report suggests that treatment with Botulinum toxin (Oculinum) is an acceptable alternative to surgical management in select patients.
The Effect of Oblique Muscle Surgery on the Axis of Astigmatism
Authors: Kushner Burton J 
Published: April 2021

ABSTRACT
A series of 22 highly astigmatic eyes in 14 patients underwent surgery, either in the form of recessing the inferior oblique, tenotomizing the superior oblique, or tightening the superior oblique. The refractive errors obtained in a masked manner six months postoperative were compared to those preoperative. Weakening the inferior oblique or tightening the superior oblique produced a long-term incyclorotation (clockwise for right eyes and counterclockwise for left eyes) of the axis of astigmatism of approximately 10 degrees. Tenotomizing the superior oblique produced a long-term excyclorotation (counterclockwise for right eyes and clockwise for left eyes) of the axis of astigmatism of about 10 degrees.
An Alternative Hypothesis for Iris Maldevelopment (Aniridia)
Authors: Beauchamp George R , Meisler David M 
Published: April 2021

ABSTRACT
Two principal hypotheses for the pathogenesis of hypoplastic iris development ("aniridia") have been proposed: 1) the ectodermal theory, positing incomplete elaboration of the cup, resulting in an absence of framework for further development; and 2) the "mesodermal" theory ,wherein inadequate migration or proliferation of mesenchymal elements is proposed.
Two eyes of two patients with persistent "anterior leaf' iris strand remnants which traverse the pupillary space are reported. They are differentiated from the previously described persistent tunica vasculosa lentis.
The presence of a persistent pupillary iris strand suggests portions of the iris may have formed and inappropriately regressed. Recent work in cell biology highlights the importance of remodeling and cell death in revealing ultimate phenotypic expression. This alternative hypothesis suggests that aniridia may be explained in part on the basis of excessive remodeling and cell death.
Acute Orbital Pseudotumor With Iatrogenic Intraorbital Air: A Diagnostic Dilemma
Authors: Wagner Alan L , Crouch Earl R , Valone James A 
Published: April 2021

ABSTRACT
A 13-year-old black female was referred with unilateral granulomatous uveitis and orbital inflammation of sudden onset. Hematologic, serologic, bacteriologic, and ultrasonographic studies along with high resolution CT scans of the orbits were employed to determine the diagnosis and appropriate treatment. Subconjunctival corticosteroid injection containing air prior to referral obfuscated the ultimate diagnosis of pseudotumor. The Pediatric Infectious Disease service delayed definitive treatment with systemic steroids. Differential diagnosis of granulomatous uveitis with orbital inflammation are discussed. CT scan has significantly advanced the diagnosis and management of orbital pseudotumor.
Excision of Individual Follicles for the Management of Congenital Distichiasis and Localized Trichiasis
Authors: Wolfley Darrell 
Published: April 2021

ABSTRACT
This paper presents a brief review of the literature regarding congenital distichiasis. The literature is confusing regarding the term distichiasis. Distichiasis should be utilized to describe congenital partial or complete accessory rows of eyelashes which exit from the posterior lid margin behind the meibomian gland orifices. The term acquired trichiasis and congenital distichiasis are significantly different.
This paper also describes a new method for microscopically dissecting and excising the follicles of distichiatic eyelashes. The technical details of the surgical procedure are described with appropriate illustrations. This procedure can also be utilized for removal of localized areas of acquired trichiasis.
The advantage of this procedure over previously utilized procedures for congenital distichiasis is the lower incidence of recurrent distichiatic lashes, combined with complete preservation of normal eyelashes and essentially no risk of cicatricial entropion following this procedure.
Accommodation in Hyperopic and Myopic School Children
Authors: Mäntyjärvi Maija I 
Published: April 2021

ABSTRACT
Binocular accommodation of 150 consecutive hyperopic and 150 myopic school children was measured during the eye examination. There were 99 girls and 51 boys in the hyperopic group and 100 girls and 50 boys in the myopic group. The ages varied from seven to 16 years. Accommodation of the hyperopic children varied from 4 to 20 D (mean 10.6 ± 3.4), and in the myopic children also from 4 to 20 D (mean 10.9 ± 2.5). The difference between these means was not statistically significant. However, hyperopic girls aged 12 to 16 years showed low values of accommodation (mean 9.0 ± 2.7) compared to the other corresponding age groups. In the second part of the study the refraction of 80 children, aged seven to 15 years, with decreased accommodation was studied retrospectively to see if they had a tendency to become myopic. The follow-up time was from one to eight years, and the accommodation at the beginning of the observation time varied from 2 to 7 D. The mean annual change of the refraction of these children was from - 0.03 to - 0.17 D. In 34 children there was no change at all, and in 12 children the change of refraction was slightly toward more hyperopia. Only three of these 80 children became myopic during the observation time. This incidence is lower than the incidence of myopia at these ages. Thus, accommodative power of hyperopic and myopic school children appears to be on the same level, and low accommodation does not predict the development of myopic refraction in the school years.
Operant Acuity of Toddlers and Developmentally Delayed Children With Low Vision
Authors: Birch Eileen , Hale Linda , Stager David , Fuller Dwain , Birch David 
Published: April 2021

ABSTRACT
The present report describes an operant procedure for the assessment of grating acuity in young and/or developmentally delayed children. Prior to testing, the child was trained to point to a grating presented on one of two equally bright screens. A reward was given to the child for each correct response. During the test, the gratings became progressively finer until the child no longer made consistently correct choices. Normative data from 90 children show improvement in grating acuity during years one to five (from 20/50 to 20/17). Results were also obtained from 100 consecutive pediatric patients who were thought to be visually unresponsive or visually impaired by the referring ophthalmologist. Overall, 12% of these children tested within the normal range, 53% had grating acuities better than 20/200 but below normal, 27% had acuities below 20/200, and 8% were not measurable. These results suggest that a wide range of visual potential exists in this population and that some of these children may benefit from visual aids and training.
Bilateral Hypermetropic Amblyopia
Authors: Schoenleber Dana B , Crouch Earl R 
Published: April 2021

ABSTRACT
A retrospective analysis was performed on the records of 184 children who had hyperopia of at least 4.0 diopters in each eye to see if bilateral amblyopia was more than just a rare occurrence and to evaluate how well it responded to treatment. Twelve patients were found to have bilateral amblyopia of 20/50 or worse. The mean age at diagnosis was four and a half years (two and a half to six and a half) and mean follow-up was 22 months (five months to seven years, four months). Ten of 12 patients showed improvement of vision to 20/40 or better in both eyes. Treatment consisted of full cycloplegic correction in all cases. Six patients had accommodative esotropia but this did not account for the bilateral nature of the amblyopia.
Bilateral amblyopia should be considered in patients with large amounts of hyperopia. It responds well to treatment with standard amblyopia therapy.
Prevention of Strabismic Amblyopia of Early Onset With Special Reference to the Optimal Age for Screening
Authors: Neumann E , Friedman Z , Abel-Peleg B 
Published: April 2021

ABSTRACT
Of 78 consecutive cases with constant unilateral esotropia diagnosed during screening and treated from the ages of seven months to three years, 82% ended up with visual acuity of 6/12 or better toward end of active treatment at the age of six to eight years. Of the cases with visual acuity of 6/12 or better at the end of treatment, 59% retained their vision when re-examined four to ten years later. The most important single parameter for the achievement of normal visual acuity was age of onset of treatment below two years and for long-term stability of the result this age dropped to 18 months. Initial large angles of esotropia had better prognosis probably because they were associated with an earlier onset of treatment.
Poor prognosis was associated with faulty or no fixation of the esotropic eye when first diagnosed, with the failure to achieve alternation and with marked ansiometry.
The optimal age for screening for strabismic amblyopia was suggested to be 12-18 months.
Theoretical Effects of Surgery on Length Tension Relationships in Extraocular Muscles
Authors: Kushner Burton J , Vrabec Michael 
Published: April 2021

ABSTRACT
The main effect of recession or resection of a rectus muscle is thought to be due to an alteration of its length-tension curve (Starlings Law). Because the subsequent straightening of the eye produces a movement of the new insertions of the rectus muscles either anteriorly or posteriorly in the orbit, the actual amount of tightening or shortening of the muscle is not equal to the amount of recession or resection. How much this phenonmenon alters the true amount of tightening or shortening of a muscle has important implications in the determination of safe amounts of surgery, which may differ if one is operating on the fixing or non-fixing eye. In addition, the size of the globe should have an important role in determing the response per millimeter of surgery.
Results of Early Treatment of Unilateral Congenital Cataracts
Authors: Robb Richard M , Mayer D Luisa , Moore Bruce D 
Published: April 2021

ABSTRACT
Twelve infants with unilateral congenital cataracts treated at Boston Children's Hospital between 1978 and 1986 have now reached the age of 3.5 years or older. All infants had cataract extractions, aphakic contact lens fitting, and occlusion of the unaffected eye by 6 months of age. Patients with posterior lenticonus or persistent hyperplastic primary vitreous were excluded from this review. Early improvement of visual acuity in the aphakic eye was monitored by preferential looking tests, and occlusion of the sound eye was adjusted accordingly. E card visual acuities are now available on all 12 children. Five patients have 20/70 or better visual acuity, three patients have between 20/100 and 20/400 vision, and four patients have less than 20/400 in the aphakic eye. Two patients whose cataract surgery was done after 4 months of age had the poorest visual results. Difficulty maintaining occlusion therapy and interruptions of contact lens wear limited the development of better vision in some patients. The visual results to date in these 12 patients suggest that early aggressive treatment of unilateral congenital cataracts is worthy of consideration in most instances.
Superior Oblique Overaction in Patients With True Brown's Syndrome
Authors: Sato Sam E , Ellis Forrest D , Pinchoff Barry S , Helveston Eugene M , Rummel John H 
Published: April 2021

ABSTRACT
The charts of all patients with the diagnosis of congenital Brown's syndrome seen between July 1983 and June 1984 were examined retrospectively. In the past, overaction of the ipsilateral superior oblique (OAISO) was felt by most authors to be absent or minimal. Our study revealed that separate observers consistently documented the presence of an OAISO in about one-fifth of the selected patients. The presence of OAISO has not been emphasized previously and still remains controversial. We felt that an extremely tight superior oblique might cause an OAISO. We therefore statistically compared its presence to the presence of a downshoot. The presence of an OAISO to abnormal head tilt, abnormal chin position, amblyopia, and abnormal stereo was also compared statistically. Finally, we emphasize a technique of forced ductions that differentiates Brown's syndrome from an inferior oblique palsy, but which also alerts the examiner to the presence of an inferior rectus restriction or other posteriorly located restrictions.
Post-Radiation Retinal Infiltrates Simulating Recurrent Retinoblastoma: A Clinical and Pathologic Case Report
Authors: Judisch G Frank , Folberg Robert 
Published: April 2021

ABSTRACT
An 8-month-old boy was found to have a sporadic unilateral stage IIa retinoblastoma, extending inferiorly and temporally from the right fovea. Within 5 weeks of diagnosis the tumor was treated with 4500 rads fractionated over 20 treatments. Examination under anesthesia (EUA) 1 month later revealed unequivocal clinical and echographic evidence of tumor regression. EUA 3 months after completion of radiation therapy revealed continued tumor regression with no evidence of new tumor formation. The third EUA, performed 6 months after radiation treatment, showed that multiple discreet gray-white retinal infiltrates had developed, predominantly in the area immediately below the regressed tumor. Because of concern that these lesions represented viable retinoblastoma, the eye was enucleated. Pathologic examination of these lesions revealed them to be collections of foamy cells containing melanin granules suggestive of pigment epithelial origin.
Optic Nerve Shadow Enlargement in the Klippel-Trenaunay-Weber Syndrome
Authors: Good William V , Hoyt Creig S 
Published: April 2021

ABSTRACT
A 10-year-old girl with Klippel-Trenaunay-Weber syndrome (KTWS) showed neuroradiology signs of enlarged optic nerve and medial rectus shadows. In 3 years of follow-up, her vision has remained normal. This is the first report of optic nerve enlargement in this syndrome. The case demonstrates that enlargement of the optic nerve shadows is not inevitably associated with visual deterioration. Optic nerve enlargement may be part of a hamartomatous process that involves other orbital contents.
Visual Acuity Measurements by Swept Spatial Frequency Visual-Evoked-Cortical Potentials (VECPs): Clinical Application in Children with Various Visual Disorders
Authors: Gottlob Irene , Fendick Michael G , Guo Suqin , Zubcov Alina A , Odom J Vernon , Reinecke Robert D 
Published: April 2021

ABSTRACT
Previous studies have indicated that visual acuities of normal infants can be estimated with good accuracy using swept spatial frequency visual-evoked-potentials (VECPs). In this report we describe acuity measurements obtained with this technique from 304 examinations performed on 135 children having various visual disorders. When possible, two or more different stimulation frequencies (8, 12, 15 or 24 contrast reversals/sec) were used in each patient, and three to eight sweep VECPs were obtained from each patient under each simulation and recording condition. High correlation coefficients (0.94 - 0.96) between the acuity estimated on each patient from either the single sweep giving the best visual acuity (BSS) or from vector averages (VeA) of the EEG data obtained from several sweeps confirmed previous findings in normal infants. We also found high correlation coefficients among BSS recorded at different temporal frequencies (0.79 - 0.97) and among comparisons of BSS or VeA acuity to optotype visual acuity (0.6 - 0.89). Children with clinically undetectable optokinetic responses showed lower visual acuity estimated by BSS than those who demonstrated optokinetic nystagmus. We conclude that the sweep VECP is a valid method, giving estimates of acuity which correlate well with optotype acuity and correspond well to other clinical findings, and that it can be useful in the clinical management of nonverbal patients.
Asymmetric Horizontal Tropias, DVD, and Manifest Latent Nystagmus: An Explanation of Dissociated Horizontal Deviation/Discussion: Asymmetric Horizontal Tropias, DVD, and Manifest Latent Nystagmus
Authors: Zubcov Alina A , Reinecke Robert D , Calhoun Joseph H 
Published: April 2021

ABSTRACT
Four patients with dissociated horizontal deviation (DHD) are described and an explanation of their horizontal comitant deviations is offered. The patients had asymmetric comitant horizontal deviations dependent on the fixing eye. All of them had unequal visual acuity (VA) and asymmetric manifest latent nystagmus (MLN) documented with eye movement recordings. The subjects appear to use convergence to reduce their nystagmus when viewing with the eye having more severe nystagmus and hence poorer vision. When patients viewed with the eye having less nystagmus, little or no convergence was exhibited. We suggest that DHD may be the manifestation of an asymmetric nystagmus blockage syndrome (NBS). The dampening effect of convergence on nystagmus has been well documented in the past and seems to apply here. The patients demonstrate that a true, but asymmetric NBS, can be found with MLN.
Long-Term Follow-up of Candida Endophthalmitis in the Premature Infant
Authors: Annable William L , Kachmer Mary Lou , DiMarco Marianne , DeSantis Diana 
Published: April 2021

ABSTRACT
In the March 1981 issue of the Journal of Pediatrics, Baley, Annable and Kleigman discussed the natural course of Candida endophthalmitis in the premature infant. We now have long-term follow-up on the three surviving infants along with follow-up on an additional eight patients. Though vitrectomy is routinely performed in adults, we recommended that it not be performed in premature infants with systemic candidiasis and associated vitreo-retinal pathology. These 1 1 infants with candidal endophthalmitis secondary to systemic candidiasis demonstrated minimal residual ocular pathology after having been treated with systemic antifungals alone. Neither vitreous taps nor intravitreal injections should be performed in infants with ocular candidiasis.
Subconjunctival Steroid in the Management of Uveal Juvenile Xanthogranuloma: A Case Report
Authors: Treacy Kevin W , Letson Robert D , Summers C Gail 
Published: April 2021

ABSTRACT
Uveal juvenile xanthogranuloma (JXG) is a rare intraocular tumor which usually occurs in very young children. Most reported cases of successfully treated uveal juvenile xanthogranuloma have received systemic steroids, irradiation or excision. Some cases have responded to topical steroids alone. We report a case of JXG with recurrent hyphemas and elevated intraocular pressures despite the use of topical steroid. This patient responded to the addition of subconjunctival steroid injection. This is the first report to our knowledge demonstrating a response to periocular steroid supplementation for uveal JXG unresponsive to topical steroids.
Complete Cryptophthalmos: Case Report With Normal Flash-VEP and ERG
Authors: Hing S , Wilson-Holt N , Kriss A , Flüeler U , Taylor D 
Published: April 2021

ABSTRACT
We report an infant with bilateral compiete cryptophthalmos as part of Fraser Syndrome. Clinical examination and recordings of the electroretinogram and flash visual evoked potential showed a functional visual pathway at retinal and post-retinal levels. Anatomical considerations and the possible complications of surgery made reconstruction of the lids and palpebral fissures inappropriate.
Assessment of Visual Acuity in Children With Severe Neurological Impairments
Authors: Adams Russell J , Courage Mary L 
Published: April 2021

ABSTRACT
We used the Teller Acuity Cards to assess visual acuity in children with severe neurological handicaps (N = 12), all of whom had been previously untestable. With every child we were able to obtain at least one estimate of visual acuity, even with those described as likely having little or no visual function. However, in all cases, performance was poorer than that of unimpaired children of the same age. Our results confirm that the test is useful for assessing visual acuity in populations who, because of significant cognitive, linguistic, and motor deficits, cannot be assessed by more traditional techniques.