bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal Perforation in Strabismus Surgery
Authors: Noel Leon-Paul , Bloom Jeffrey N , Clarke William N , Bawazeer Ahmed 
Published: April 2021

ABSTRACT
Purpose: Perforation of the retina is a major complication of strabismus surgery. The reported incidence of perforation varies from 0.13% to 12%. This study was undertaken to determine, from a large collaborative database, the incidence of suspected and unsuspected retinal and choroidal injury in pediatrie horizontal muscle surgery.
Method: All children with horizontal strabismus surgery seen between September 1992 and October 1995 were examined with indirect ophthalmoscopy immediately following their procedure. Surgery was performed by both resident and attending physicians. Cases involving muscle reoperation, high myopia, or patients with connective tissue disorders were excluded.
Results: Strabismus surgery was performed on 765 patients, who underwent 1 129 muscle recessions and 349 muscle resections. These children also had 161 vertical or oblique muscle procedures performed. Intraocular trauma resulting from horizontal muscle surgery was noted in 14 patients, including three retinal perforations. One of these patients was treated with cryotherapy; the other two received no therapy other than intraoperative and postoperative antibiotics.
Discussion: The incidence of retinal perforation was 0.4% and the incidence of choroidal injury without perforation was 1.4% in this large series of children undergoing horizontal strabismus surgery. Retinal detachment or endophthalmitis did not develop during the 6week follow-up period.
Spectrum of Pediatric Dacryocystitis: Medical and Surgical Management of 54 Cases
Authors: Campolattaro Brian N , Lueder Gregg T , Tychsen Lawrence 
Published: April 2021

ABSTRACT
Background: Dacryocystitis in infants and older children is a serious complication of congenital or acquired nasolacrimal duct obstruction. To define the modes of presentation and treatment strategies of this disorder better, we reviewed the clinical courses of 54 children treated for dacryocystitis at St Louis Children's Hospital.
Methods: Clinical, neuroradiologic, and laboratory data were collated for all cases of dacryocystitis treated from 1990 to 1995. Average follow up of the children in this consecutive series was 1.75 years (range, 4 months to 5 years).
Results: Of the 54 patients, 36 (67%) had chronic lowgrade dacryocystitis, which was treated with nasolacrimal duct probing on an outpatient basis. The remaining 18 patients (33%) had acute dacryocystitis, which was treated with a combined medical/surgical strategy. Medical treatment consisted of hospital admission for administration of intravenous antibiotics followed by inpatient surgery, which varied according to the age of the patient and the clinical history: 1) Acute dacryocystitis in neonates was treated surgically by nasolacrimal duct probing and nasal endoscopy for excision of intranasal duct cyst; 2) Acute dacryocystitis with periorbital cellulitis was treated surgically by nasolacrimal duct probing; 3) Acute dacryocystitis due to facial trauma was treated surgically by dacryocystorhinostomy and stent placement; and 4) Acute dacryocystitis complicated by orbital abscess was treated by inferior orbitotomy for orbital abscess drainage, simultaneous nasolacrimal duct probing, and stent placement.
Conclusion: Dacryocystitis in the pediatrie population may present in either chronic or acute forms. An effective and safe treatment for acute dacryocystitis is hospital admission, both for administering intravenous antibiotics and monitoring to rule out orbital cellulitis or abscess formation. Intravenous antibiotic therapy is followed within a day or two by surgery tailored to the clinical history. In the majority of both chronic and acute cases, nasolacrimal duct probing appears to be an effective treatment strategy.
Diplopia Following Subcutaneous Injections of Botulinum A Toxin for Facial Spasms
Authors: Wutthiphan Sorot , Kowal Lionel , O'Day Justin , Jones Stephen , Price Jane 
Published: April 2021

ABSTRACT
Purpose: To study the incidence, cause, recovery time, and prevention of diplopia following subcutaneous injection of botulinum A toxin for the treatment of facial spasms.
Methods: Patients who experienced diplopia after botulinum A toxin injections had their deviations examined in detail. When the muscle that caused diplopia was identifiable, the injection closest to that muscle was omitted in the next treatment in an attempt to prevent diplopia.
Results: Of 250 patients receiving about 1500 sets of injections, 25 (1.7%) incidents of diplopia occurred in 10 patients. Excluding two patients who declined further treatment after having diplopia on their first botulinum A toxin treatment, seven of the remaining eight patients had multiple incidents of diplopia. The most common pattern of diplopia was "uncertain diagnosis." The most common identifiable cause of diplopia was paresis of the inferior oblique muscle. Omission of the injection into the central portion of the lower eyelids in the next treatment prevented recurrence of diplopia in only one of the four patients. No significant correlation between botulinum A toxin doses injected and times to recovery was noted.
Conclusions: Diplopia following botulinum A toxin treatment is uncommon. Seven patients (3% of patients studied) had 22 episodes of diplopia (88% of episodes). When diplopia occurs, it tends to recur on reinjection, sometimes with a prolonged recovery time. This response may not be dose dependent. The extraocular muscles of some patients may be more susceptible to chemodenervation than others, or botulinum A toxin may diffuse to extraocular muscles more easily in some patients than in others.
Retinopathy of Prematurity in Infants Less Than 29 Weeks' Gestation: 3x/£ Years Pre- and Postsurfactant
Authors: Kennedy John , Todd David A , Watts Jane , John Elizabeth 
Published: April 2021

ABSTRACT
Objective: To determine the effects of surfactant on retinopathy of prematurity (ROP).
Design: YJe compared infants for VA years both before and after the introduction of surfactant in our neonatal intensive care unit (NICU) using prospectively collected data. Exogenous surfactant (Exosurf) was introduced into our NICU on July 1, 1991.
Methods: We compared the incidence and severity of ROP in two groups of infants born at less than 29 weeks' gestation who required cryo- or laser therapy. Premature infants born during the first 3% years following the introduction of surfactant were compared with those born during the 31/2-year period prior to its introduction. The infants were examined by one ophthalmologist (J.K.) and classified according to the International Classification of ROP.
Results: A total of 124 infants born presurfactant and 152 infants born postsurfactant were examined for the presence of ROP. No significant difference between the two groups regarding any stage of ROP or the necessity for treatment was found. In infants of less than 27 weeks' gestation, a significant reduction In the number requiring cryo- or laser therapy was noted (12 of 48 examined [25.0%] vs 6 of 62 examined [9.7%], respectively; P<0.05).
This decreased need for treatment, however, was found in infants without hyaline membrane disease who did not receive surfactant.
Conclusion: Exosurf has had no significant impact on the incidence or severity of ROP. Due to its effect on improved survival rates, the surfactant produces a larger proportion of infants at risk of developing ROP. Other changes in NICU protocol may be causing a reduction in the incidence of severe ROP.
Cortical Visual Impairment Following Perinatal Hypoxia: Clinicoradiologic Correlation Using Magnetic Resonance Imaging
Authors: Casteels I , Demaerel P , Spileers W , Lagae L , Missotten L , Casaer P 
Published: April 2021

ABSTRACT
Purpose: To evaluate the value of magnetic resonance Imaging (MRI) in the visual prognosis of cortical visual impairment following perinatal hypoxia.
Methods: MRI findings of 19 babies with the diagnosis of a perinatal hypoxic-ischemic insult and cortical visual impairment (CVI) were reviewed. Two groups of patients based on gestational age were compared. Babies with a gestational age s*34 weeks were included in group 1(n=8). Infants <34 weeks' gestation were included in group 2 (n=11). All 19 children underwent MRI.
Results: Normal MRI always correlated with better visual outcome, regardless of the gestational age at which the insult occurred. Among infants born at or later than 34 weeks' gestation, a favorable visual recovery occurred in two with normal MRI findings. The presence of infarcts or periventricular leukomalacia indicated that full visual recovery would not occur. Among infants born before 34 weeks' gestation, the MRI findings were normal in two who had a favorable visual outcome. A normal visual cortex and the absence of periventricular leukomalacia were helpful in prognostieating the visual outcome. A general delay in the myelination - particularly in the myelination of the optic radiation - was a common finding and until now has not been described in children with CVI routinely.
Conclusion: MRI's ability to follow the process of myelination may be of predictive value. MRI, therefore, should be obtained in a child with CVI following perinatal hypoxia.
Tuberous Sclerosis in Infancy
Authors: Mullaney Paul B , Jacquemin Claude , Abboud Emad , Karcioglu Zeynel A 
Published: April 2021

ABSTRACT
Purpose: To report two infants with tuberous sclerosis who initially were considered to have retinoblastoma.
Patients and Methods: An 8-day-old infant was referred with small tumors in the posterior poles of both eyes. A left microphthalmos with ciliochoroidal coloboma was present. Computed tomographic (CT) scanning of the brain showed scattered high-density subependymal foci in the lateral ventricle thought to be consistent with calcification resulting from intrauterine viral infection. Argon laser photocoagulation was applied to lesions in the right eye. Because one tumor was situated on the retina straddling the coloboma in the left eye, external beam radiotherapy was administered.
A 5-month-old girl presented with a large mass in a left microphthalmic eye. Calcification was present on B-scan ultrasonography and CT scanning. Vitreous seeding was noted to originate from the tumor. The contralateral eye manifested four small gray translucent retinal tumors in the posterior pole. CT scan and magnetic resonance imaging (MRI) revealed multiple periventricular subependymal lesions, including one at the foramen of Monro.
Results: Repeated examinations in the younger child under anesthesia revealed small new retinal lesions that appeared to enlarge gradually. She developed intractable seizures and her electroencephalogram revealed a modified hypsarrhythmia recording. A careful review of available CT scans and MRI displays suggested the diagnosis of tuberous sclerosis. The child's most recent examination under anesthesia revealed multiple newly developed hamartomas. In the older child, prompt diagnosis was made on the basis of the intracranial radiologie findings.
Conclusion: Retinal hamartoma presentation may vary in infancy. Small, initially fleck-like gliotic lesions appear to enlarge gradually and eventually may form gray, translucent tumors. Large astrocytic hamartomas of the retina associated with tuberous sclerosis may resemble retinoblastoma, particularly if the mass is large, calcified, and associated with vitreous seeding. Although ophthalmic presentation was reminiscent of retinoblastoma in both patients, radiologie evidence of subependymal hamartomas pathognomic for tuberous sclerosis helped establish the correct diagnosis. We stress the importance of intracranial radiologic findings in this regard.
A Comparison of Prophylactic Ondansetron Hydrochloride and Droperidol for Strabismus Repair in Adults
Authors: Doe Erin A , Jones Perry , O'Hara Mary A 
Published: April 2021

ABSTRACT
Background: Prophylactic administration of an antiemetlc is a common procedure for patients undergoing strabismus surgery. Droperidol and ondansetron hydrochloride are commonly used antiemetlcs. This study compared the rates of postoperative nausea and vomiting (PONV) in adult patients undergoing strabismus surgery with prophylactically administered Droperidol or ondansetron hydrochloride.
Methods: A double-masked, randomized, prospective study was conducted comparing droperidol with ondansetron hydrochloride when administered prophylactically to adults undergoing strabismus surgery.
Results: Forty-five patients entered the study with a mean age of 30 years. Twenty percent of patients had nausea immediately postoperatively and 37% had nausea before discharge with no significant differences between groups. Overall rate of emesis, time in the recovery room, and time to discharge was not significantly different between the droperidol and ondansetron hydrochloride group.
Conclusion: No real differences in the ability to prevent PONV between the two medications were found in this study.
Sarcoidosis Presenting as Multilobular Limbal Corneal Nodules
Authors: Hegab Samiha M , Al-Mutawa Samia A , Sheriff Sayed M 
Published: April 2021

ABSTRACT
Purpose; To review reported external ocular manifestations of sarcoidosis and to present bilateral, m u It i lobular, nodular, limbal, corneal nodules as being a unique manifestation of the disease.
Patients and Methods: A 16-year-old Saudi girl presented with bilateral, multilobular, solid, limbal nodules, with a vascular supply from the conjunctiva! vessel, and associated membraneous conjunctivitis and healed trachoma. The Schirmer's test revealed less than 2 mm in both eyes with tear meniscus less than 2 mm. Biopsy of an associated palpebrai conjunctiva! nodule was performed, in addition to a gallium scan, chest X-ray, and a serum angiotensin-converting enzyme (SACE) level.
Results: The culture showed ß-hemolytlc streptococci. Gallium scan showed intake by both lacrimal glands. Her chest X-ray results were normal, as was the SACE level. Biopsy of the excised conjunctiva! nodule disclosed a noncaseatlng granulomatous reaction with epithelioid and giant cells, and chronic inflammatory cell infiltrate confirming a diagnosis of sarcoidosis.
Conclusion: A multilobular, nodular, perilimbal mass as a unique manifestation of sarcoidosis is presented. A streptococcal membraneous conjunctivitis and heated trachoma superimposed. A review of sarcoidosis of the external eye is included.
A New Objective Digital Computerized Vision Screening System
Authors: Granet David B , Hoover Adam , Smith Amanda R , Brown Stuart I , Bartsch Dirk-Uwe , Brody Barbara 
Published: April 2021

ABSTRACT
Purpose: Fewer than 40% of children in the crucial younger-than-4 age group are evaluated for visual problems by pediatricians. This is due to impracticality from either a clinical or practice efficiency standpoint. Current photoscreening methods require trained readers and suffer from significant subjectivity and interobserver variability. We report a cross-sectional, double-masked study using new digital imaging with objective, automated, computerized image analysis.
Methods: Two-hundred six children aged 9 months to 16 years were prospectively studied in a University-based pediatrie ophthalmology practice. Images were taken by volunteers with a modified digital camera which, when downloaded, were analyzed within 35 seconds by new image analysis software. The analysis was compared to a masked review of a complete pediatrie ophthalmic exam.
Results: Overall agreement between physician and the objective computerized analysis was 86.9%. Positive predictive value was 91%, sensitivity was 89%, and specificity was 83%.
Conclusions: This automated digital imaging screening system eliminates human bias and provides accurate and immediate results. The system requires no special expertise.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:251-256.
Bilateral Posterior Fixation Sutures on the Medial Rectus Muscles for Correction of Nonaccommodative Esotropia With Infantile Onset Criteria
Authors: Rizk Akmal 
Published: April 2021

ABSTRACT
Background: Bilateral posterior fixation sutures on the medial rectus muscles can be used in the management of nonaccommodative esotropia with criteria indicative of infantile onset. The postoperative results of posterior scierai fixation of bilateral medial rectus muscles on ocular motility and the angle of esotropia in different directions of gaze, as well as on the near point of convergence, have been studied.
Methods: Twenty-six patients suffering nonaccommodative esotropia of the infantile onset type, showing variable angles, adduction overshooting, and esodeviation, which had started within the first year of life, were examined. The angle of esotropia was measured at near, distance, and in the different directions of gaze. All patients underwent postequatorial scierai fixation of both medial rectus muscles at 12 mm to 14 mm from the insertion, depending on the preoperative angle of esotropia.
Results: With the alternate prism cover test, 20 patients (76.9%) showed an angle <10 prism diopters (?) in the primary position, as well as in the different directions of gaze. Fifteen of the 20 patients (57.7%) even showed simultaneous perception at near and at distance with Bagolint's striated glasses. Six patients were under-corrected.
Conclusions: Bilateral posterior fixation of the medial rectus muscles is a good procedure to correct the angle of esotropia in patients who meet the following criteria: essential infantile esotropia, showing overacting medial rectus muscles, variable angles, and nonaccommodative convergence excess.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:320-325.
Visual Capacity and Prader-Willi Syndrome
Authors: Fox Robert , Sinatra Robbin B , Mooney Megan A , Feurer Irene D , Butler Merlin G 
Published: April 2021

ABSTRACT
Purpose: Prader-Willi syndrome (PWS) refers to a genetic disorder induced by an anomaly on chromosome 1 5 occurring with a frequency of one in 10,000 to 20,000. It is characterized by a unique set of features including infantile hypotonia, obesity in childhood, small hands and feet, hypogonadisrn, and mental retardation. Reported here are the results of ophthalmic examinations of persons with PWS, together with results from controls comparable in age, percentage of body fat, and intelligence. These data bear on the hypothesis that the ocular anomalies in PWS are unique to this syndrome.
Method: A comprehensive investigation of PWS brought children and adults to Vanderbilt University for extended testing, which included an ophthalmic examination. Genetic analysis determined unequivocally the PWS diagnosis and identified subgroups - deletion and maternal disomy. A group of persons without PWS but generally comparable in age, body composition, and intelligence served as controls.
Results: Significant differences between the deletion and disomy subgroups were not found for the clinical ophthalmic measures. The incidence of anomalies in the combined PWS was similar to those reported in previous studies. A similar pattern was present in the control group except for myopia and stereopsis. An effect of genetic subgroup, however, was observed for random element stereopsis with the maternal disomy group having a greater degree of impairment.
Conclusion: The overall similarity between the PWS and control groups on all measures except myopia and stereopsis suggest that many of the anomalies in PWS found in prior studies are due to factors inherent in a general dysfunctional population, rather than reflective of an ocular signature unique to PWS.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:331-336.
Maldevelopment of Neural Crest Cells in Patients With Typical Uveal Coloboma
Authors: Ozeki Hironori , Shirai Shoichiro , Nozaki Miho , Ikeda Kozo , Ogura Yuichiro 
Published: April 2021

ABSTRACT
Purpose: To clarify the pathogenesis of ocular and systemic anomalies associated with typical uveal coloboma.
Methods: The records of 72 patients with typical uveal coloboma (35 males and 37 females) treated at Nagoya City University Hospital during a 16-year period were reviewed.
Results: Typical uveal coloboma was bilateral in 33 patients and unilateral in 35 patients; 4 patients were unclassified because of severe contralateral micraphthalmos. Uveal coloboma was an isolated defect in 23 (37%) patients. Other ocular anomalies were present in 19 (31%) patients, systemic anomalies were found in 7 (11%) patients, and both other ocular and systemic anomalies were noted in 13 patients (21%). The associated ocular anomalies included microphthalmos in 28 eyes of 23 patients, persistent pupillary membrane in 28 eyes of 18 patients, and posterior embryotoxon in 20 eyes of 15 patients. The accompanying systemic anomalies included ear anomalies, retarded growth, and retarded development in 18 patients; heart anomalies in 1 3 patients; genital hypoplasia in 1 2 patients; and congenital facial palsy in 10 patients. The collection of malformations known as the CHARGE association was diagnosed in 14 (19%) patients.
Conclusion: Abnormal development of neural crest cells appeared to be responsible for the majority of associated ocular and systemic anomalies in patients in the present series, suggesting that typical uveal coloboma may be related to maldevelopment of the neural crest cells. The present findings indicated that ophthalmologists should be aware of the possible association of typical uveal coloboma with systemic anomalies.
Journal of Pediatrie Ophthalmology and Strabismus 1999;36:337-341.
The Traditional Treatment of the Psychiatric Patient in Nigeria
Authors: Daramola S O 
Published: April 2021

ABSTRACT
Fifty Yoruba male patients were interviewed in an outpatient psychiatric clinic in Abeokuta, Nigeria. The interview revealed that most Yoruba people seek traditional healers for their physical and emotional illnesses. The type of treatment obtained from the healers has a significant meaning for each patient who seeks that kind of treatment. The native healers and the (Aladura) Church sect are commonly patronized, followed by the (Alfa) Moslem healers. The type of treatment received by the patients were: native drugs, charms to wear, venesection, exorcism, prayers with candlelight, animal sacrifice, medicinal water for washing, and restraint. A few patients attended the general hospital and health center where they received drugs and injections. It was only a negligible percentage of the patients who sought direct psychiatric care, when they were emotionally ill.
Remarriage: Parental Perceptions of Steprelations with Children and Adolescents
Authors: Palermo Eleanor 
Published: April 2021

ABSTRACT
This study was designed to determine if relationships between stepparents and adolescents differed from those between stepparents and younger children. Utilizing a questionnaire developed by Duberman,1 responses from remarried couples (N=50) were used to determine a steprelationship score for each child. The scores for children under age 13 and 13 and over both at the time of the parental marriage termination and the remarriage were compared. Chi-square techniques were used in the data analysis. No significant differences were found between the two groups. The results of this study suggest that factors, other than the child's age, may influence the steprelationship. Possibilities suggested include unresolved conflicts in the child and/or parents, the child's relationship with one or both natural parents, or the natural parents' relationship. This population merits further research consideration as society attempts to assimilate the growing numbers of these families.