bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Retinoblastoma With Indirect Ophthalmoscope Laser Photocoagulation
Authors: Shields Carol L , Shields Jerry A , Kiratli Hayyam , De Potter Patrick V 
Published: April 2021

ABSTRACT
Introduction: The indirect ophthalmoscope laser photocoagulation delivery system is relatively new and is potentially applicable for treating selected small retinoblastomas. There has been very little reported on the results achieved with this laser delivery system in the treatment of retinoblastoma.
Methods: We reviewed all patients with retinoblastoma managed by indirect ophthalmoscope laser photocoagulation on the Ocular Oncology Service between July 1, 1991 and July 1, 1994. The individual tumor size, location, and proximity to the optic disc and foveola, as well as the laser power, duration, and number of sessions, were recorded. We assessed the tumor response to treatment and the visual outcome of the patients.
Results: There were 30 retinoblastomas in 20 eyes of 18 patients managed with indirect ophthalmoscope laser photocoagulation over the 3-year period. The mean tumor base was 2.1 mm (range: 1 mm to 8 mm); the mean tumor thickness, 1.2 mm (range: 0 mm to 3 mm). The tumor margin was a mean of 6.5 mm (range: 0 mm to 19 mm) from the foveola, and 7.7 mm (range: 0 mm to 22 mm) to the optic disc. In general, it required a power of approximately 350 mW and a continuous duration lasting 1 to 4 seconds to obtain satisfactory obliteration of feeding blood vessels. The tumor responded in one to three sessions (mean: 1.9 sessions per tumor). Complete regression occurred in 21 tumors (70%) and local recurrence in nine (30%). The recurrent tumors were successfully treated with plaque radiotherapy in seven cases and cryotherapy in two cases. The central vision was minimally distorted due to foveal traction from the laser treatment in three cases.
Conclusion: Indirect ophthalmoscope laser photocoagulation is an effective conservative method to manage selected small retinoblastomas. Tumors treated by this technique should be followed closely due to the moderate risk for local recurrence.
The Surgical Correction of Paralytic Strabismus Using Fascia Lata
Authors: Salazar-León José A , Ramírez-Ortíz Marco A , Salas-Vargas Marisela 
Published: April 2021

ABSTRACT
Objective: To present the results of a new technique designed to restore and maintain alignment, exclusively In the primary position, in patients with paralytic strabismus.
Methods: In five patients (seven eyes, total) with exotropia secondary to third-nerve palsy, we fixated the globe with a strip of fascia lata sutured onto both the medial aspect of the eye and the nasal bone periosteum. We characterized the ocular deviation in the primary position with prism diopters the day before the operation, during the initial 24-hour period, and at subsequent monthly postoperative evaluations. We documented all evaluations with photographs.
Results: In all patients, the ocular position improved with the surgery. No further change of the ocular position was noted during the follow-up period, which ranged from 15 to 35 months (mean follow up 22.5 months). All the patients tolerated the collagenous tissue without complications.
Conclusions: This procedure can be a useful addition to the current surgical techniques for management of strabismus secondary to third-nerve paralysis.
Screening for Uveitis in Juvenile Rheumatoid Arthritis
Authors: Boone Michael I , Moore Terry L , Cruz Oscar A 
Published: April 2021

ABSTRACT
Background: Uveitis associated with juvenile rheumatoid arthritis (JRA) is an important cause of visual impairment in children. Because uveitis is often asymptomatic in this age group, frequent ophthalmologic screening examinations are recommended. Recent reports have found a decrease in the prevalence and severity of uveitis in JRA when compared to older data.
Methods: The charts of 52 consecutive patients with JRA seen over a 30-month period were retrospectively reviewed.
Results: Eye examination identified uveitis in five (12%) patients. All patients with uveitis were female, ANA positive, and had pauciarticular-onset arthritis. Three patients had the onset of uveitis before the age of 2. AM patients have maintained good visual acuity and have not developed serious sight-threatening ocular complications over the follow-up period.
Conclusions: Although the prevalence and severity of JRA-associated uveitis may be decreasing, we strongly recommend continued strict adherence to the current screening guidelines.
Clinical Practice Guidelines for the Management of Orbital Cellulitis
Authors: Uzcátegui Nicolás , Warman Roberto , Smith Alfred , Howard Cleve W 
Published: April 2021

ABSTRACT
Purpose: A retrospective study was performed to review the management of periorbital and orbital cellulitis at Miami Children's Hospital, between January 1, 1993 and February 15, 1996.
Resufts: One hundred and one patients were included in this study. The variables analyzed in this study included age, sex, length of hospital stay, imaging studies, laboratory tests, and microbiology specimens collected. Patients were classified according to the modified Chandler classification. Average length of stay for our patient population was 4.5 days. Data regarding the radiologie studies, laboratory tests, and microbiology yield of specimens were analyzed.
Conclusions: The incidence of orbital infection, manifested by lid swelling alone is much more common (stages I and II) than orbital infection involving postseptal findings (stages III, IV, and V); 84.16% compared with 15.84%, respectively. An updated approach and a general guideline for the management of periorbital and orbital cellulitis according to the clinical staging of the process is presented.
Surgical Technique, Visual Outcome, and Complications of Pediatric Intraocular Lens Implantation
Authors: Simons Brad D , Siatkowski R Michael , Schiffman Joyce C , Flynn John T , Capó Hilda , Muñoz Michelle 
Published: April 2021

ABSTRACT
Purpose: To evaluate retrospectively the surgical technique, visual outcome, and complications of pediatric cataract extraction (CE) and intraocular lens (IOL) implantation.
Methods: Forty-three patients ages 2 to 12 underwent CE with IOL implantation with a minimum follow up of 1 month.
Results: All IOLs were implanted in the posterior chamber with 17 (40%) in the bag, 25 (58%) sulcus fixated, and one (2%) partially in the bag (one haptic in the bag, one in the sulcus). Primary posterior capsulectomy was performed in 12 (28%) cases. A final visual acuity of at least 20/40 was achieved in 26 (60%) and at least 20/80 in 32 (74%). Posterior capsule opacification developed in 18 (42%) and pupillary capture in 7 (16%). Seventeen (40%) patients had postoperative visual acuity worse than 20/40. Of these, nine (53%) had this visual outcome as a result of presumed amblyopia.
Conclusions: Posterior chamber IOL implantation affords a safe and effective method of visual rehabilitation for cataractous children 2 years of age and older. Amblyopia and antecedent posterior segment trauma, rather than IOL-related or surgical complications, are the limiting factors in final visual outcome.
Journal of Pediatric Ophthalmology & Strabismus 1999; 36:118-124.
Intraocular Lens Implantation in Children and Youth
Authors: Malukiewicz-Wisniewska Grazyna , Kaluzny Józef , Lesiewska-Junk Hanna , Eliks Iwona 
Published: April 2021

ABSTRACT
Purpose: To evaluate the safety and the effectiveness posterior chamber intraocular lenses (PCIOLs) in children and youth with cataract.
Methods: Retrospective study of operative and postoperative results was based on 146 eyes in 125 children ages 6 to 18 years (mean: 11.7 years) who underwent extracapsular cataract extraction with IOL implantation in the period from 1986 to 1996. Follow up was 1 to 10 years.
Outcome measure: Best corrected distance and near visual acuity, operative complications, and early and late postoperative complications. Exclusion criteria were uveitis, retinal detachment, prior glaucoma, and systemic diseases.
Results: Early postoperative complications were observed in 12.3% of cases including iritis in 7.5%, and transient corneal edema in 3.4% of eyes. Posterior capsule opacification requiring capsulotomy was needed in 81.5% of eyes after 8.5 years. YAG laser capsulotomy was performed in 68.1% and surgical intervention in 26.8% of cases. In 5.1% of the cases, both techniques were used. In 74.7% of patients, best corrected visual acuity of 0.5 or better was achieved. The mean postoperative spherical equivalent was +0.35 diopters (D, SD 1.35). Spectacle-corrected near visual acuity of 0.5 on the Snellen chart was obtained in 82.8% of eyes.
Conclusion: IOL implantation in children older than 6 years appears to be an efficacious, satisfactory, and safe procedure in the management of pediatric cataract.
Journal of Pediatric Ophthalmology and Strabismus 1999;36:129-133.
Strabismus Surgery Using the Adjustable Suture Technique
Authors: Wygnanski-Jaffe Tamara , Wysanbeek Yigal , Bessler Emanuel , Spierer Abraham 
Published: April 2021

ABSTRACT
Background and Objective: To determine the results of adjustable suture technique used in horizontal muscle surgery.
Materials and Methods: Seventy-eight charts of patients who underwent strabismus surgery between the years 1993 and 1995 were examined retrospectively. The study included 35 cases of esotropia (ET), and 43 cases of exotropia (XT). The results of strabismus surgery were measured and compared 1 day after adjustment; the final results between 6 and 24 months after the surgical procedure.
Results: Adjustment was required in 39% of all patients. The highest rate of adjustment was required in patients who underwent monocular surgery for XT (51%), and the lowest rate of adjustment was undertaken in patients who underwent monocular surgery for ET (16%). Mean changes in the angle of deviation between 1 day after surgery to the last follow up was 2.2 prism diopters (?) (±11.2 ?) for cases of esotropia, and 4.6 ? (±8.7 ?) for exotropia. The most significant drift was found in patients with XT who underwent binocular surgery 6.8 ? (±0.9 ?) and the smallest drift was found in patients with ET who underwent binocular surgery 5.2 ? (±5. 6 ?).
Conclusion: Esotropie and exotropic patients have a tendency to drift towards their original deviation postoperatively. It is possible, therefore, that mild overcorrection in the early postoperative period will result in better long-term results.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:184-188.
A Randomized Comparison of Prism Adaptation and Augmented Surgery in the Surgical Management of Esotropia Associated With Hypermetropia
Authors: Hwang Jeong-Min , Min Byung-Moo , Park Soo-Chul , Oh Sei Yeul 
Published: April 2021

ABSTRACT
Objective: To compare both motor and sensory surgical outcomes for patients with esotropia associated with hypermetropia managed with an augmented surgery based on the average of the near deviation with and without correction vs preoperative prism adaptation.
Methods: Forty-three patients with esotropia associated with hypermetropia entered a randomized prospective evaluation of augmented surgery (group A, 27 patients) versus prism adaptation (group P, 16 patients). The formula for augmenting the amount of the rectus muscle recession was based on the average of the near deviation with and without correction in group A, and the prism-adapted angle of deviation in group P.
Results: In group A, postoperative deviations of 8 prism diopters (Δ) or less at distance and at near were achieved in 24 patients (88%), and in 22 patients (81%), respectively. In nine prism responder patients, postoperative deviations of 8 Δ or less at distance and at near were achieved in eight patients (89%). In seven nonresponder patients, postoperative deviations of 8 Δ or less at distance and at near were achieved in six patients (86%). No significant difference between the two groups in terms of near and distance deviation at 1 and 3 months postoperatively were noted.
Conclusion: No significant difference existed in the motor outcomes between the two groups, or between the prism responder and prism nonresponder groups. Further detailed studies must be made in a large number of patients.
Journal of Pediatric Ophthalmology and Strabismus 1999;36:196-200.
Long-term Results of Bimedial Rectus Recessions in Infantile Esotropia
Authors: Tolun Hayati , Dikici Kemal , Ozkiris Abdullah 
Published: April 2021

ABSTRACT
Background: Congenital esotropia has a deviation of 50 or more prism diopters (Δ). Generally, surgical alignment of the eyes is the accepted treatment but surgical techniques differ.
Methods: A total of 54 patients were evaluated. Surgery was done at a mean age of 28 months. Bimedial rectus recessions up to 8 mm were performed.
Results: The mean preoperative deviation was 70 Δ of esotropia. Our success rate with a uniform approach was 66.6%.
Conclusions: Contrary to the selective approach for large angle congenital esotropia, we do not consider initial surgery on three or more muscles. Our method is quicker, simpler, less traumatic, and leaves the lateral rectus muscles unoperated for patients requiring a second surgery.
Journal of Pediatric Ophthalmology and Strabismus 1999;36:201-205.
Ophthalmologic Screening of Deaf Students in Oregon
Authors: Brinks Mitchell V , Murphey William H , Cardwell William , Otos Maurine , Weleber Richard G 
Published: April 2021

ABSTRACT
Purpose: To determine the frequency of Usher's syndrome and other ocular disease in students receiving special education services for the deaf in Oregon and to assess the amount of existing ophthalmologic surveillance of this population. A special emphasis was placed on screening for Usher's syndrome.
Methods: From 1980-1990, a prospective twocenter visual screening program of 231 deaf students in schools throughout Oregon was conducted using an ophthalmic questionnaire, complete eye examinations, and electroretinography. Students were between the ages of 10 and 21 years and participated on a volunteer basis. Findings for etiology and severity of visual loss and the scope of ophthalmologic surveillance within this population were analyzed.
Results: Two hundred seventeen of the 231 students examined received electroretinograms. Significant ocular pathology was found in 1 1 1 (48%) of the students. The most common diagnoses were congenital rubella (21%), significant uncorrected ametropia (16%), and ocular hypertension (9%). Five students were diagnosed with Usher's syndrome. Of the students with significant ocular pathology, only 37% were actively followed by an ophthalmologist.
Conclusion: Deaf students in Oregon's schools had a high frequency of eye disease. Early diagnosis and treatment of eye disease in this population could benefit the quality of life of these students. This study alerted the providers of special education services for the deaf and the ophthalmologic community in Oregon of the need for better eye care for these students.
Journal of Pediatric Ophthalmology and Strabismus 2001 ;38:1 1 -1 5.
Checklist for the Evaluation of Low Vision in Uncooperative Patients
Authors: Salati Roberto , Schiavulli Ornella , Giammari Giuseppina , Borgatti Renato 
Published: April 2021

ABSTRACTPurpose: To present a checklist for the evaluation of low vision in uncooperative patients; in this specific case, children with neuroEogicai deficits.Method: The checklist includes several behavioral indicators obtainable with a standard clinical examination. Each test is assigned a score (0=failure, ]=success). The final visual quotient score is obtained by dividing the partial score by the total number of tests performed. Eleven children with cerebral visual impairment were studied using behavioral and preferential looking techniques.Results: Visual quotient was >0 in all patients, indicating that residual visual function was always detectable. Average visual quotient was 0.74.Conclusion: Visual quotient can be useful both for follow-up examinations and comparison and integration with other evaluation methods (behavioral and instrumental) of residual visual capacity. In particular, if combined with preferential looking techniques, visual quotient testing permits characterization of the entire spectrum of low vision.Journal of Pediatrie Ophthalmology and Strabismus 20(?;38:90-94.
Near-Work Activity and Myopia in Rural and Urban Schoolchildren in China
Authors: Saw Seang-Mei , Hong Rong-Zhao , Zhang Ming-Zhi , Fu Zhi-Fu , Ye Mei , Tan Donald , Chew Sek-Jin 
Published: April 2021

ABSTRACTPurpose: To examine the prevalence of myopia in rural and urban schoolchildren in Xiamen, China, and to assess the impact of environmental factors on rates of myopia.Methods: Second-grade children attending either a city (n=1 79) or rural (n=91) school in Xiamen, China, were examined using cycloplegic autorefraction and biometry. Detailed questions on socioeconomic status, near-work activity, reading and writing habits, and family histories of myopia were asked in a face-to-face interview using a standard questionnaire.Results: The prevalence of myopia was 1 9.3% (95% confidence interval [Cl], 12.3, 29) in the city and 6.6% (95% Cl, 2.4, 14.3) in the countryside. The average hours per day children spent reading and writing outside of school was 2.2 hours in the city compared with 1.6 hours in the countryside (P<.0001). In both schools, the odds ratio for total reading and writing adjusted for parental history of myopia, was 2.2 (95% Cl, 1 .1, 4).Conclusion: These data suggest the prevalence of myopia is higher in the city than in the countryside. One possible explanation for these different rates could be that schoolchildren in the city spend more time reading and writing outside of school compared with children in the countryside. Myopic children in both the city and the countryside spent more time reading and writing compared with nonmyopic children. This increased near-work activity may contribute to the prevalence of myopia.Journal of Pediatric Ophthalmology and Strabismus 2001;38:149-155.
Ocular and Clinical Manifestations of Möbius' Syndrome
Authors: Cronemberger Mônica Fialho , Moreira José Belmiro de Castro , Brunoni Décio , Mendonça Tomás Scalamandre , Alvarenga Eliézia Helena de Lima , Rizzo Ana Maria Pfeifer Pereira , Diogo Sandra Maria Martins 
Published: April 2021

ABSTRACT
Purpose: To assess ocular and otorhinolaryngologic manifestations and intellectual ability in patients with Möbius' syndrome.
Methods: Patients with Möbius' syndrome underwent prospective ophthalmic, genetic-clinical, and otorhinolaryngologic examinations as well as psychological evaluation.
Results: Sixteen patients with Möbius' syndrome between the ages of 8 months and 10.6 years underwent ocular examination. Esotropia was present in 12 (75%) patients and V-pattern in 8 (50%). Limited abduction was present in 30 (93.8%) eyes, and limited adduction was present in 21 (65.6%) eyes. The most frequent refractive error was compound hyperopic astigmatism (13 [40.6%] eyes). Eleven (68.8%) patients had lagophthalmos and 12 (75%) patients had bilateral epicanthus. Unilateral amblyopia was present in 2 (12.5%) patients. Clubfoot was the most common lower limb defect (7 [43.8%] patients). Cranial nerve impairments included paralysis of 7th nerve in all patients, paralysis of the 12th nerve in 13 patients, and paralysis of the 9th and 10th nerves in 3 patients. Evaluation of intellectual ability showed that 4 (25%) patients had normal intelligence. The mothers of 3 (1 8.8%) patients used misoprostol during the first trimester of pregnancy.
Conclusion: Prominent ophthalmic features of Möbius' syndrome in this series were esotropia, Vpattern, abduction limitation, and compound hyperopic astigmatism. Intellectual assessment showed some degree of mental retardation in 75% of patients. Möbius' syndrome is associated with prenatal exposure to misoprostol.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:156-162.
Retinal Detachment Associated With Subthreshold Retinopathy of Prematurity
Authors: Gurdian Silvio J , Gehlbach Peter L , MD Alex P , Robertson Joseph E 
Published: April 2021

ABSTRACT
Purpose: To report a series of infants who progressed from mild retinopathy of prematurity (ROP) to severe ROP with retinal detachment without demonstrating detectable threshold disease.
Methods: Between January 1993 and August 1998, seven infants at Oregon Health Sciences University, followed in accordance with the Cryotherapy for Retinopathy of Prematurity Study (CRYO-ROP) protocol, progressed to retinal detachment despite documentation that threshold had not been reached. This outlying subset of patients was analyzed and compared to the cohort in the CRYO-ROP study.
Results: Six of 7 patients were male, 6 (86%) patients had symmetric disease, and all patients were born outside the study hospital. Mean birthweight was 877 g and mean gestational age was 26 weeks. Mean postconceptual age at the time of retinal detachment was 41 weeks. Because of bilateral detachment in 3 patients, the total number of study eyes is 10. Failure to achieve threshold resulted from insufficient clock hours or insufficient stage in 2 eyes and lack of plus in 8 eyes. Zone I disease was present in 1 eye.
Conclusion: Rarely, despite adhering to ROP examination protocol, the retina may detach without demonstrating antecedent threshold disease. Very low birthweight is a factor that may lead to a less predictable course. This study found a lack of plus disease results in failure to reach threshold more often than the occurrence of insufficient clock hours of stage 3 disease. Further study is needed to determine if selected cases of subthreshold ROP may benefit from ablative therapy.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:279-283.
a collaborative model for university nursing education and agency staff development
Authors: Kornfeld-Jacobs Gila , Karshmer Judith F 
Published: April 2021

ABSTRACT
A model is proposed for the integration of the education of senior nursing students and staff at a mental hospital, maximizing utilization of time and resources. A pilot study employed small group techniques with faculty as facilitators and resource persons, with the dual purpose of increasing competence and reducing communication barriers.
Four students and four nursing staff participated in weekly meetings, alternating supervision groups (2 groups, each composed of 1 faculty, 2 students and 2 staff) with discussion groups (2 faculty, 4 students and 4 staff),
Evaluation tools used did not yield significant differences between pre- and post-tests. However, objective and subjective indices point to positive changes of attitudes between all unit staff and students, improved therapeutic skills of students and staff, both on individual and group level.
Ongoing group meetings of patients run by students and staff resulted.
CONTROVERSIES AND CHALLENGES OF RITUAL ABUSE
Authors: Valente Sharon 
Published: April 2021

ABSTRACT
Children who have survived ritual abuse have endured physical, psychological, and sexual trauma; brainwashing; and mind-altering drugs. Their trust in adults has been eroded. Their coping strategies include anxiety, denial, self-hypnosis, dissociation, and self-mutilation. Although reports of ritual abuse initially seem hard to believe, nurses have a responsibility to detect clues to abuse, diagnose the child's responses, and recognize controversial issues regarding ritual abuse.
To evaluate ritual abuse, nurses should avoid interview strategies that influence the child's recall (e.g., coaching, suggestions) and recognize that some reports are discounted as false memories because they emerge from fantasy, distortions, innocent deceptions, false beliefs, lies, or adult coaching. Nurses play an important role in case finding and treatment. They can evaluate clues to ritual abuse to reduce sources of error in assessment, build a child's trust, monitor their own attitudes toward ritual abuse, and intervene to increase selfesteem, empathy, boundary establishment, and coping. Nurses have an important opportunity to detect and begin healing the wounds caused by a child's abuse.