bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blue Cone Monochromatism
Authors: Weiss Avery H , Biersdorf William R 
Published: April 2021

ABSTRACT
Blue cone monochromatism (BCM) is a subtype of achromatopsia in which the blue cone mechanism predominates. Each of the four patients in this study had BCM proven by their having peak spectral sensitivities in the blue region of the visible spectrum (near 440 nm). Clinically, the diagnosis was suspected because of xlinked inheritance, the presence of acuities better than 20/200 in two patients and myopia ranging from -1.75 to 15.00 diopters in three patients. Congenital nystagmus was the presenting sign in three of the four patients. Examination of the fundi was uniformly normal. The distinctive spectral properties of BCM were demonstrated by the American Optical H-R-R and the Panel D-15 tests. All affected patients correctly identified three of the four blue-yellow plates and a variable number of the red-green plates in the American Optical H-R-R test. The study patients consistently made errors oriented along the protan and deutan axes but they made none along the tritan axis. The authors conclude that the results of these two color discrimination tests are useful in diagnosing BCM.
Necrotizing Scleritis Following Strabismus Surgery for Thyroid Ophthalmopathy
Authors: Kaufman Lawrence K , Folk Eugene R , Miller Marilyn T , Tessler Howard H 
Published: April 2021

ABSTRACT
Necrotizing scleritis with inflammation of the right eye developed after bilateral eye muscle surgery for thyroid ophthalmopathy. Debilitating pain, delay in onset, and Involvement of the sclera distinguish this condition from anterior segment ischemia. The surgery may have acted as a nonspecific trigger in an eye at risk for scleritis. Necrotizing scleritis has occurred infrequently after types of eye surgery but, to our knowledge, has not been previously reported as a complication of eye surgery.
Epibulbar Complex Choristoma Involving the Bulbar Conjunctiva and Cornea
Authors: Hayasaka Seiji , Sekimoto Mihoko , Setogawa Tomoichi 
Published: April 2021

ABSTRACT
A male infant was born with a fleshy mass between the temporal bulbar conjunctiva and cornea in the right eye. Four weeks after birth the patient underwent excision of the epibulbar tumor and a lamellar keratoplasty. Histopathologic examination of the excised tumor revealed cartilage, lobules of lacrimal gland, and adipose tissue, indicating an epibulbar complex choristoma. Although the graft remained almost completely transparent, right amblyopia ensued. Epibulbar complex choristoma involving the conjunctiva and cornea is a rare condition.
Polaroid Photorefractive Screening of Infants
Authors: Hsu-Winges Charlene , Hamer Russell D , Norcia Anthony M , Wesemann Henrike , Chan Christine 
Published: April 2021

ABSTRACT
We modified a Polaroid SE camera for use as a photoretinoscope. A total of 187 infants between 2 and 18 months of age were photographed using this device. About half of these infants (97) participated in a double blind study in which the results of photorefraction were compared with those of standard cycloplegic retinoscopy. Eighty-three infants were photographed without cycloplegia. Thirty-four infants were photographed while cyclopleged. Photographs were evaluated for significant refractive errors and other ocular abnormalities.
The effectiveness of the camera system to screen for significant refractive errors without the use of cycloplegia was assessed. Infants were identified to be at risk by photorefraction if, in any photograph, a hyperopic bright crescent calculated to be ≥ +1.25 D was present in the pupil. Clinically significant refractive errors were defined by the results of cycloplegic retinoscopy: "at-risk" infants had either 3.5 D or more hyperopia in either eye, or astigmatism In either eye ≥ 2.5 D, or anisometropia ≥ 1.5 D. With these clinical criteria and the above photographic screening criterion, the camera's sensitivity and specificity were 83% and 69%, respectively.
The present system compares favorably with earlier, more sophisticated units in alerting practitioners to potentially significant refractive errors in infants. Additionally, as a screening tool, this device offers the benefits of being inexpensive and easy to use, and of providing immediate feedback.
Changes in the Aphakic Refraction of Children With Unilateral Congenital Cataracts
Authors: Moore Bruce D 
Published: April 2021

ABSTRACT
Forty-two infants who presented to the Children's Hospital in Boston with unilateral congenital cataracts and had cataract surgery by 6 months of age received serial refractions (N = 369) of their aphakic eyes during the first 4 years of life. The 14 patients followed most intensively (185 refractions) showed a rapid decrease in mean spherical equivalent during the first year of life from +30.75 D to +26.36 D, with a less rapid decrease thereafter (24 months, +23.02 D; 36 months, +21.19 D; 48 months, +20.86 D). The rate of change per month decreased from .43 D between 1 and 6 months, .37 D between 6 and 12 months, -30 D between 12 and 18 months, .24 D between 18 and 24 months, and less than .19 D per month thereafter. This study shows that the refractive error of the aphakic eye of patients treated for unilateral congenital cataracts decreases most rapidly during infancy and less rapidly during the next few years of childhood. This information will be helpful in facilitating the treatment of these infants by allowing an approximation of their future contact lens refractive power changes.
Fusion and Suppression: Development and Loss
Authors: Pratt-Johnson J A 
Published: April 2021

ABSTRACT
A retrospective study (coauthored with Geraldine Tillson) of 118 patients with the congenital esotropia syndrome Is described. All patients were aligned with surgery and, in some cases, glasses as well, within 10 prism diopters of orthotropia before the age of 2 years and had remained so aligned for at least a year.
A standardized final examination was performed on patients over the age of 6 years, after at least 5 years' follow up, to study the effect of significant refractive error, amblyopia, nystagmus, dissociated vertical divergence, and inferior oblique overaction on the sensory outcome. None of the patients obtained central fusion. Fifty-three of 118 obtained peripheral fusion with at least 5? of fusiona! amplitude. Twenty-eight of the 53 fusers had stereopsis. The findings did not show any factors to explain why 65 did not obtain fusion. A congenital lack of the potential to develop fusion is postulated.
The development of fusion and suppression is discussed with relevant references. Evidence is presented that the anatomical location of the lesion in central fusion disruption is in the midbrain. Fusion may be lost, in visual adults, without developing suppression from prolonged sensory deprivation. Examples include unilateral cataract, unconnected unilateral aphakia, and unilateral severe herpetic keratitis.
Motility Disturbances After Molteno Implants
Authors: Christmann Linda M , Wilson M Edward 
Published: April 2021

ABSTRACT
Molteno implants are gaining wide acceptance for refractory glaucoma In both children and adults. Such surgery led to vertical strabismus In three patients. Two children developed an inability to elevate the globe after Molteno implants were placed superiorly. One adult, whose Molteno Implant was placed interiorly, could not fully depress the globe postoperatlvely, and experienced vertical diplopia. This complication of Molteno implants was explored using forced auction testing and surgery. We feel a likely explanation for this Is a Faden or posterior fixation suture effect induced by scarring under the rectus muscle. Patients undergoing this surgery should be counseled about possible postoperative diplopia, an especially devastating complication when the implant is placed inferiorly.
Iatrogenic Inferior Rectus Palsy
Authors: Brodsky Michael C , Fritz Katherine J , Carney Susan H 
Published: April 2021

ABSTRACT
We examined two patients who developed unilateral inferior rectus muscle palsy following inferior oblique myectomy. Surgical exploration showed a normal inferior rectus muscle and tendon in both patients. Surgical correction consisted of inferior rectus resection in one patient and inferior rectus resection combined with an ipsilateral superior rectus recession in the other. We propose inadvertent excision of the lateral portion of the inferior rectus muscle during inferior oblique myectomy as the probable mechanism of inferior rectus injury.
Ocular Torsion-Direct Measurement With Indirect Ophthalmoscope and Protractor
Authors: Madigan William P , Katz Norman N K 
Published: April 2021

ABSTRACT
Objective measurement of the optic nerve head (ONH)foveal angle, representing the torsional status of 40 eyes in 20 normal patients, was performed by fundus photography and compared to a method utilizing an indirect ophthalmoscope and protractor described herein. Photography established a mean ONH-foveal angle of 7.03° (SD 2.94°). Comparison with the indirect/protractor method revealed a mean difference of 1.10° (SD 0.99) with a range of 0° to 4° between methods. The indirect/ protractor method seems to provide a rapid, inexpensive, and accurate method of determining the degree of ocular torsion when compared to the fundus photograph method which requires greater patient cooperation and investment in time and equipment.
The ONH-foveal angle varies widely among normal individuals (0° to 16°). Variation between left and right eyes of the same individual was not significant (1 .15°, SD 1.39°), and if greater than 4°, probably represents cyclovertical muscle dysfunction or restrictive orbitopathy. The converse, however, may not always be true as individuals with less than 4° difference between eyes may have cyclovertical muscle imbalance.
Eye Muscle Prosthesis
Authors: Scott Alan B , Miller Joel M , Collins Carter C 
Published: April 2021

ABSTRACT
We inserted a silicone rubber elastic band along the course of a paralyzed lateral rectus and of a paralyzed superior oblique to restore alignment and to provide a spring against which the antagonist could pull. The lateral rectus band has been in place for 7 years. It provides alignment and a field of single binocular vision of 20°. The superior oblique band has been in place for 1 7 months. It provides alignment and single vision over 30° from the primary position except for a restriction in upgaze-adduction to 25° (Brown syndrome) and in downgaze-adduction to 20°. Such engineered elastic bands are a useful addition to current surgical techniques for management of cases of paralysis and restriction.
The Ocular Manifestations of the Sturge-Weber Syndrome
Authors: Sullivan Timothy J , Clarke Michael P , Morin J Donald 
Published: April 2021

ABSTRACT
Sturge-Weber syndrome (SWS) is a rare neurooculocutaneous disorder. The ocular component manifests as glaucoma and vascular malformations of the conjunctiva, episclera, choroid, and retina. The authors reviewed the records of and recalled for examination 51 consecutive patients with a diagnosis of SWS seen at The Hospital for Sick Children, Toronto, Ontario, Canada, from 1980 to 1991. Of the 51 patients, 36 (71%) had glaucoma, 26 experienced onset before 24 months of age and the remainder after 66 months of age, 35 (69%) had conjunctival or episcleral hemangiomas, and 28 (55%) had choroidal hemangiomas, which were bilateral in 12 patients. Other ocular manifestations (retinal vascular tortuosity, iris heterochromia, retinal detachment, and strabismus) also occurred. Thirty-four of 51 (67%) glaucomatous eyes had a final visual acuity of 20/40 or better, or central, steady, and maintained fixation in each eye.
Artifacts in Fusion and Stereopsis Testing Based on Red/Green Dichoptic Image Separation
Authors: Simons Kurt , Elhatton Kelly 
Published: April 2021

ABSTRACT
A red/green anaglyph stereotest (TNO) was administered to a group of patients who had anisometropic amblyopia, and the Worth 4-Dot test for fusion to two groups of strabismus patients. Both tests were administered twice, with the red/green lens position of the glasses reversed between eyes for the second administration. Twelve of 15 patients with anisometropic amblyopia exhibited a stereo acuity difference of 2:1 or more, and 18 of 89 strabismic patients changed Worth 4-Dot fusion or suppression status, between the two positions of the glasses. A group of seven strabismic patients who showed the reversal effect on the Worth 4-Dot test had the results of one glass4 position discrepant with those of a geometrically identical achromatic test. It appears that the red/green format can introduce artifacts in binocular vision testing. Testing twice, with the red/green glasses reversed between trials, will prevent misinterpretation of binocular status and may provide diagnosticai Iy useful information.
Establishing a Mutual Reality
Authors: O'Connell Michael 
Published: April 2021

ABSTRACT
Nursing stories are a vehicle for sharing the uniqueness of the nurse-patient relationship. In this article, a nurse-patient engagement within an acute mental health inpatient unit is described and viewed through various lenses. Consideration is given to literature on reflective thinking. Each lens lends itself to exploring the reflective thinking that occurred for the author. The author's personal perspective on an ethic of care is presented.
Sodium Bicarbonate Reduces Pain Associated With Ophthalmic Nerve Blocks
Authors: Manka Richard L , Gast Thomas J 
Published: April 2021

ABSTRACT: Administration of local nerve blocks for ophthalmic surgical procedures causes pain resulting in an unpleasant and stressful experience for the patient. A prospective, randomized, double-masked study compared injection pain of anesthetic solutions used for facial and retrobulbar nerve blocks. Anesthetic solutions to which sodium bicarbonate had been added were compared with anesthetic solutions without added sodium bicarbonate.
Pain on injection of both facial and retrobulbar nerve blocks was significantly less (P = .0009 and P < .0001 respectively), without diminution of effectiveness of either type of nerve block, in the group using anesthetic solutions to which sodium bicarbonate had been added. Refract Corneal Surg 1991;7:186-187.)
Corneal Lathing Using the Excimer Laser and a Computer-controlled Positioning System
Authors: Biowski Robert , Homolka Peter , Barisani-Asenbauer Talin , Baumgartner Isabella , Husinsky Wolfgang , Kaminski Stephan , Lametschwandtner Anton , Muss Wolfgang , Grabner Günther 
Published: April 2021

ABSTRACT
PURPOSE: To present the excimer laser corneal shaping system (ELCS-S), an add-on device to the Keratom, a commercially available 193-nm excimer laser built by Schwind.
METHODS: The system is designed for the preparation of donor corneas under sterile conditions using the ultraviolet laser to offer greatest possible flexibility. Lenticules for planolamellar grafting and refractive epikeratoplasty, as well as donor buttons for penetrating keratoplasty can be computer-designed by the surgeon or technician and lathed with the system.
RESULTS: Using the excimer laser corneal shaping system (ELCS-S) on human donor corneas, the central surface of the epikeratoplasty lenticule exhibited only narrow, flat concentric notches corresponding to the single lathing steps. Transmission electron microscopy revealed a damage zone of less than 0.3 µta in close approximation to the treated surface. The final thickness revealed a difference of less than ±53 µm from the intended, initially programmed value. Ultrastructural studies showed the perpendicular stromal surface of the penetrating keratoplasty buttons to be smooth with minimal protrusion of Descemet's membrane. Endothelial injury was observed in a zone averaging between 40 and 100 µta adjacent to the cutting edge only.
CONCLUSION: The excimer laser corneal shaping system (ELCS-S) allows a computer-controlled, surgeon-designed, sterile preparation of lamellar and penetrating corneal grafts with the use of the excimer laser. This could offer significant advantages in comparison to presently available systems for lamellar dissection and trephination. [J Refract Surg 2000;16:23-31]
Arcuate Transverse Keratotomy Remains a Useful Adjunct to Correct Astigmatism in Conjunction With Photorefractive Keratectomy
Authors: Kapadia Manasvee S , Krishna Rohit , Shah Sujal , Wilson Steven E 
Published: April 2021

ABSTRACT
PURPOSE: To retrospectively evaluate the effectiveness of paired, arcuate transverse keratotomy (Arc-T) performed prior to or after photorefractive keratectomy (PRK) to correct low to moderate amounts of natural or laser-induced astigmatism.
METHODS: Spherical PRK was performed in 730 eyes for myopia of -1.00 to -7.00 D. PRK with arcuate transverse keratotomy was performed in 150 of these eyes; we studied 123 eyes that did not have PRK enhancement. Arc-T was performed prior to PRK in all 37 study eyes with astigmatism of 1.50 D or more at the preoperative examination. Arc-T keratotomy was performed after PRK in 86 study eyes for residual astigmatism of +0.75 D or more and uncorrected visual acuity of 20/30 or worse.
RESULTS: Arc-T before PRK group: PRK was performed at a mean 1.0 ± 1.5 months after Arc-T. Mean astigmatism decreased from +2.40 ± 0.6 D (range, 1.00 to 4.00 D) before Arc-T to 0.60 ± 0.60 D (range, 0 to 2.25 D) after Arc-T (P < .0001). Net change in astigmatism was 1.80 ± 0.60 D (range, 0.80 to 2.80 D) and mean reduction was 75%. Spherical equivalent refraction changed from -4.10 ± 1.90 D (range, -0.25 to -8.10 D) to -4.40 ± 1.80 D after Arc-T (P = .002). Mean change in spherical equivalent refraction after Arc-T was -0.30 ± 0.50 D (range, -1.10 to +0.40 D).
Arc-T after PRK group: Arc-T was performed at a mean 3.5 ±1.9 months after PRK. Six months after Arc-T, astigmatism was decreased from +1.50 * 0.60 D to 0.40 ± 0.40 D (P = .04). Net change in astigmatism at 6 months was 1.10 ± 0.60 D and mean reduction was 74%. Vector change in astigmatism magnitude was 1.30 ± 0.60 D (range, 0 to 4.00 D) at 6 months and vector change in astigmatism axis was 65° ± 68°. Spherical equivalent refraction did not change when Arc-T was performed after PRK for eyes with low astigmatism (P = .4). Arc-T retreatment was performed in 6 of 37 (16%) eyes that had Arc-T before PRK and 18 of 86 (21%) eyes that had Arc-T after PRK (P = .12).
CONCLUSION: Arcuate transverse keratotomy performed prior to PRK for high astigmatism or after PRK for lower levels of residual astigmatism effectively improved visual outcome. Coupling was less predictable for high levels of astigmatism correction with Arc-T. [J Refract Surg 2000;16:60-68]
Lower Intraoperative Flap Complication Rate With the Hansatome Microkeratome Compared to the Automated Corneal Shaper
Authors: Walker Mark B , Wilson Steven E 
Published: April 2021

ABSTRACT
PURPOSE: The purpose of this study was to retrospectively compare the incidence of intraoperative flap complications, such as partial flaps, donutshaped flaps, central corneal cuts, and complete caps with the Hansatome and Automated Corneal Shaper (ACS) microkeratomes.
METHODS: All laser in situ keratomileusis (LASHi) procedures performed by a single surgeon with the Hansatome or Automated Corneal Shaper in which intraocular pressure was verified with a pneumotonometer were reviewed.
RESULTS: A total of 90 eyes had LASHi with the ACS microkeratome. Six of the ACS eyes (6.7%) had intraoperative flap complications (4 partial flaps, 1 donut-shaped flap, 0 central corneal cuts, 1 complete cap). Partial flaps and donut-shaped flaps were replaced without laser application and the procedure repeated 2 to 3 months later. Two of these eyes lost 2 lines and one lost 1 line of spectacle-corrected visual acuity at 6 months after repeat LASHL The eye with the donut-shaped flap was treated with transepithelial photorefractive keratectomy (PRK) and had no change in spectaclecorrected visual acuity at 6 months after PRK. The eye with the complete cap had no change in spectacle-corrected visual acuity after laser ablation. Five hundred ninety-eight (598) eyes had LASHi with the Hansatome microkeratome. Two of the Hansatome eyes (0.3%) had a flap complication (1 partial flap and 1 donut-shaped flap). The first eye retained spectacle-corrected visual acuity at 6 months after repeat LASEK. The second eye had transepithelial PRK to eliminate the donut shaped flap with no loss of spectacle-corrected visual acuity at 6 months after surgery. The difference in flap complications between the two procedures was statistically significant (P < .01). There were no flap displacements following surgery in either group.
CONCLUSION: Intraoperative flap complications are less likely to occur with the Hansatome microkeratome than with the ACS microkeratome. [J Refract Surg 2000;16:79-82]
Photospallation: A New Theory and Mechanism for Mid-infrared Corneal Ablations
Authors: Hoffman Hanna J , Telfair William B 
Published: April 2021

ABSTRACT
PURPOSE: A new mechanism for ablating corneal tissue is proposed, based on photospallation with short pulse mid-infrared (IR) laser radiation.
METHODS: By using a judicious combination of high absorption, short pulses, and low fluences, ablation with this process can potentially remove tissue in a highly localized manner with submicron collateral thermal damage characteristics similar to those achieved by excimer lasers. We provide a brief qualitative overview of aspects of the spallation process that distinguish it from the more familiar photoablation and photothermal mechanisms.
RESULTS: Results of preliminary parametric analysis based on one-dimensional models of thermoelastic expansion are summarized.

CONCLUSION: These preliminary calculations lend support to the conjecture that corneal tissue can be removed effectively with strongly absorbed nanosecond pulses from a mid-IR laser, using operational fluence levels of less than 200 mJ/cm
p 2
. [J Refract Surg 2000;16:90-94]
Wavefront-guided Laser in situ Keratomileusis: Early Results in Three Eyes
Authors: Mrochen Michael , Kaemmerer Maik , Seiler Theo 
Published: April 2021

ABSTRACT
PXJRPOSE: Wavefront optical aberrations induced by refractive corneal surgery correction of myopia are probably the reason for deterioration of visual performance in some eyes after surgery. Customized photoablation of the cornea to correct both the sphero-cylindrical refractive error as well as individual optical aberrations may improve postoperative visual acuity and visual performance.
METHODS: In 3 eyes of 3 patients the wavefront deviations were measured by means of an aberrometer of the Tscherning-type. Based on these measurements an ablation pattern was determined and applied during a LASIK procedure using a Wavelight Allegretto scanning spot excimer laser with a spot size of 1 mm and a laser repetition rate of 200 Hz. The 3 eyes are part of a prospective study on wavefront-guided LASK started in July 1999.
RESULTS: At 1 month after LASBK, all 3 eyes had gained up to 2 lines of best spectacle-corrected visual acuity. Best spectacle-corrected visual acuity improved to 20/10 in all 3 eyes, uncorrected visual acuity was 20/10 in two eyes, and 20/12.5 in 1 eye 1 month postoperatively. The wavefront deviations were reduced by 27% on average. At 3 months, best spectacle-corrected visual acuity was 20/10 in 2 eyes and 20/12.5 in 1 eye.
CONCLUSION: Wavefront-guided LASBK is a feasible approach in refractive corneal surgery. Optimized ablation patterns may further improve the visual results. [J Refract Surg 2000;16:116-121]