bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of Residual Dissociated Vertical Deviation With Inferior Rectus Resection
Authors: Kapp Mary Beth Esswein , von Noorden Gunter K 
Published: April 2021

ABSTRACT
The effectiveness of an ipsilateral 4-millimeter resection of the inferior rectus muscle was evaluated as a treatment of recurrent dissociated vertical deviation. Thirty-six patients who had an unsatisfactory outcome after 7- to 9-millimeter recession of the superior rectus muscle had an ipsilateral inferior rectus muscle resection. The dissociated vertical deviation was fully corrected in 18 patients and improved in 15 patients. Only three patients (8%) had an unsatisfactory result. Multivariate analysis of four preoperative features including the amplitude of the dissociated deviation, the age at diagnosis, the age at surgery, and the degree of amblyopia failed to define any factors that could predict surgical success.
Persistent Tunica Vasculosa Lentis as a Sign of Congenital Myotonic Dystrophy
Authors: Blayney Marc , Clarke William N 
Published: April 2021

ABSTRACT
We describe the ocular findings in eight patients with congenital myotonic dystrophy in the newborn period. While three infants had normal findings, five infants had evidence of persistent tunica vasculosa lentis (TVL) at gestational ages ranging from 34 to 40 weeks. Atrophy of vessels on the anterior lens capsule is normally complete by 34 weeks gestation and its persistence should suggest congenital infection or congenital myotonic dystrophy. Diagnosis of myotonic dystrophy has serious implications for the baby and the mother, in whom the condition may have not been recognized earlier.
Reappraisal of Occlusion Therapy for Severe Structural Abnormalities of the Optic Disc and Macula
Authors: Yang Lucy L H , Lambert Scott R 
Published: April 2021

ABSTRACT
The visual function of some children with structural defects of the macula or optic nerve has previously been shown to improve with occlusion therapy. The charts of five children, ages 4 to 8 years, who had various types of severe structural abnormalities were reviewed. Two patients had optic nerve hypoplasia; there was one case each of foveal hypoplasia, posterior persistent hyperplastic primary vitreous, and retinopathy of prematurity. All the patients had undergone extensive amblyopia therapy prior to referral.
In three children, occlusion therapy had been initiated and continued intensively for several months or longer without recognizing the presence of a severe, underlying structural abnormality. In none of the five children was there any clear-cut evidence of visual improvement. In some cases, the long period of enforced iatrogenic vision impairment resulted in significant psychosocial harm and developmental delay. In all five cases, it was structural changes rather than amblyopia that ultimately accounted for visual loss.
The authors stress the importance of a meticulous fundus examination directed at finding organic defects prior to patching. Close, periodic monitoring of visual function should then follow. To spare the child unnecessary psychosocial impairment, it is advisable to follow established recommended thresholds for terminating occlusion therapy.
Periocular Infection After Strabismus Surgery
Authors: Kivlin Jane D , Wilson M Edward 
Published: April 2021

ABSTRACT
Fewer than 15 cases of cell ulitis and subconjunctival abscess after extraocular muscle surgery have been reported in detail. In an effort to provide greater information about this serious complication, the members of the American Association for Pediatric Ophthalmology and Strabismus (AAPO&S) were surveyed and contributed cases were analyzed.
Among the 25 cases of cellulitis, there was a predominance of preschool age patients and Staphylococcus aureus cultures. Many cases presented after a normal initial postoperative visit. The most common symptoms were marked swelling and pain. Possible predisposing factors included unsuspected sinusitis, eye rubbing, and poor hygiene. Two patients had documented bacteremia, but no patient developed endophthalmitis. All cases resolved on antibiotics, but only five patients were successfully treated with oral antibiotics alone.
Periocular Infections after extraocular muscle surgery can present after a normal initial postoperative visit. Symptoms of marked swelling and pain are cause for closer inspection. S. aureus is the most common organism and oral antibiotics alone can fail to halt the infection.
Retinopathy of Prematurity in Discordant Twins
Authors: Fellows Rae R , McGregor Mary Lou , Bremer Don L , Rogers Gary L , Miller Dennis 
Published: April 2021

ABSTRACT
Discordant twins may be at increased risk for retinopathy of prematurity (ROP) because of factors related to their unequal growth. Discordancy is defined as a difference of 15% or more in the birth weights of the two infants. We examined the data in 26 sets of discordant twins from six NICUs, including birth weight, gestational age, sex, and highest grade of ROP. Thirty-eight percent (10) of the lower birth weight infants had higher grades of ROP than their twin. Twenty-three percent (6) of the heavier birth weight twins had higher grades of ROP than their smaller siblings. Three infants reached threshold, and five were prethreshold. In every case, their twin siblings had mild or no ROP. Thirty-eight percent of the twins (10) had the same ROP outcome.
Levodopa/Carbidopa Treatment for Amblyopia in Older Children
Authors: Leguire Lawrence E , Walson Philip D , Rogers Gary L , Bremer Don L , McGregor Mary Lou 
Published: April 2021

ABSTRACT
The purpose of the present study is to determine how long visual function improves during levodopa/ carbidopa with part-time occlusion treatment in older amblyopic children.

A 7-week open clinical trial of levodopa (0.55 mg/kg, three times daily) with 25% carbidopa combined with part-time occlusion (3 hours/day), was undertaken in 15 older (mean age, 8.87 years) amblyopic children. Visual acuity, fusion, and stereo acuity were measured at baseline, at weeks 1, 3, 5, and 7 during treatment, and 6 weeks following the end of all treatment. Health status was assessed by physical examination, questionnaire, and standard laboratory tests (CHEM 20, complete blood cell count [CBC], and differential). The results revealed that visual acuity in the amblyopic eye improved for 5 weeks, from 20/170 at baseline to 20/107, then stabilized for the last 2 weeks. Visual acuity also improved in the dominant eye by 0.6 lines, from 20/19 to 20/16. At the 6-week follow up, visual acuity in the amblyopic eye remained at 20/107 (paired t=4.78, df= 14, P<.001), a 37% improvement. Thirty-three percent of the subjects demonstrated improved fusion from baseline to the 7-week trial that was maintained at follow up (χ
p 2
= 3.97, P<.05). Stereo acuity did not significantly change. Physical exam (blood pressure, body temperature, respiration, heart rate) and standard laboratory tests remained normal and side effects were minimal.

It is concluded that levodopa/carbidopa combined with part-time occlusion in older amblyopic children improves visual acuity for 5 weeks then stabilizes, and can lead to improvements in visual acuity and in fusion over a period of at least 6 weeks following cessation of treatment, with minimal side effects.
Interstitial Keratitis as Presenting Ophthalmic Sign of Sarcoidosis in a Child
Authors: Lennarson Peter , Barney Neal P 
Published: April 2021

ABSTRACT
Interstitial keratitis is a rarely occurring sign in sarcoidosis. We report a case of childhood sarcoidosis with initial ocular presentation as interstitial keratitis. Erythema nodosum preceded the ocular findings by 4 years and arthritis developed 1 year after ocular findings developed. Although no history of intraocular inflammation was present, there was evidence of inactive chorioretinitis and vitritis found at initial presentation. Systemic steroids were used to treat the patient's skin lesions and topical steroids to treat his corneal inflammation. He developed posterior uveitis and optic nerve edema both of which were responsive to oral steroids. Two years after the presentation of his ocular findings, the onset of pulmonary symptoms and resultant transbronchial biopsy confirmed his diagnosis of sarcoidosis.
Hydroxypropylmethylcellulose and Sodium Hyalorunate in Adjustable Strabismus Surgery
Authors: Ferreira Rosane C , Lamberts Marianne , Moreira José Belmiro C , Campos Mauro S Q 
Published: April 2021

ABSTRACT
The efficacy of hydroxypropylmethylcellulose and sodium hyaluronate as adjuncts during adjustable strabismus surgery was evaluated experimentally. Fifteen randomized NZA rabbits underwent a bilateral 4-mm recession of the superior rectus followed by a 0.05 mL injection of submuscular hydroxypropylmethylcellulose 2% (HPMC) in one eye and sodium hyaluronate 1% (Healon) in the other eye. Five additional rabbits (10 eyes), used as controls, underwent the same procedure, but no viscoelastic was injected after surgery. The force needed to move the muscle 4 mm toward its original insertion was measured immediatety and 24 hours after the operation, using a force gauge. The force needed to adjust the muscles increased 326.0%, 98%, and 124.7%, respectively in the control, Healon and HPMC groups (p<0.001). No significant difference was found between the two viscoelastic substances. Histologic evaluation of the operation sites disclosed similar inflammation in both controls and viscoelastic groups (p=.5960).
Glaucoma and Findings Simulating Glaucoma in the Rubinstein-Taybi Syndrome
Authors: Brei Timothy J , Burke Miles J , Rubinstein Jack H 
Published: April 2021

ABSTRACT
Information is reviewed on the ophthalmologic findings in 614 individuals with Rubinstein-Taybi syndrome (RTS): The data were collected from the world literature, from communication with colleagues and with families of individuals with RTS, and from personal observations. Particular emphasis is given in this article to the association of RTS with glaucoma and five other findings that may be confused with glaucoma (corneal lesions, megalocomea, colobomatous or cystic optic nerve, excavation of papilla, and large cup-to-disc ratio). A case report is presented including autopsy results on a 5-year- old black female with RTS, corneal lesions, colobomas of the optic nerves, and normal intraocular pressure.
Tonometry in Pediatric Patients: A Comparative Study Among Tono-pen, Perkins, and Schiötz Tonometers
Authors: Bordon Arnaldo F , Katsumi Osamu , Hirose Tatsuo 
Published: April 2021

ABSTRACT
Measuring the intraocular pressure (IOP) in children can be difficult. We compared the accuracy of IOP measurements in pediatrie patients using three tonometers: Perkins, Schiötz, and Tono-pen. Seventy-seven children (132 eyes; average age, 1 year, 7 months; range, 1 month to 60 months), mainly afflicted with retinopathy of prematurity (107 eyes), were evaluated. A good correlation (r=0.867) was found between the Tono-pen and the Perkins tonometers. No statistical difference was found between the mean difference of IOP values obtained with the Tonopen and the Perkins (P>.05). The Schiötz measurements were significantly higher than those obtained with the Perkins and the Tono-pen tonometers (P<.05).We concluded that the Tono-pen tonometer has a higher correlation coefficient, comparable to the Perkins tonometer, and can be used reliably to assess IOP in pediatrie patients.
Treatment of Congenital Adduction Palsy With Synergistic Divergence
Authors: Mohan Kanwar , Gupta Rajeev , Sharma Ashok , Gupta Amod 
Published: April 2021

ABSTRACT
Objective: To report on successful management of congenital adduction palsy with synergistic divergence by performing weakening surgery on the superior and inferior oblique muscles.
Methods: We performed a total tenotomy of the lateral rectus muscle, followed by resection of the medial rectus muscle and tenotomy of the superior oblique and myectomy of the inferior oblique muscles in a patient who had congenital adduction palsy with synergistic divergence.
Results: Total tenotomy of the lateral rectus muscle had no effect on synergistic divergence, resection of the medial rectus muscle reduced it to some extent and tenotomy of the superior oblique and myectomy of the inferior oblique muscles further reduced this phenomenon. The improvement in synergistic divergence was maintained at 2Va years later at follow up.
Conclusions: Weakening surgery on the superior and inferior oblique muscles should be considered in the management of synergistic divergence.
Reduction in Binocular Enhancement of the Visual-evoked Potential During Development Accompanies Increasing Stereoacuity
Authors: Sloper John J , Collins Alan D 
Published: April 2021

ABSTRACT
Purpose: To study the maturation of normal binocular vision.
Methods: Binocular visual function has been studied and monocular and binocular pattern reversal visualevoked potentials (VEP) recorded in 20 normal subjects aged 5 to 43 years.
Results: Stereoacuity improved significantly between the age of 5 and adulthood. Mean stereoacuity for eight children measured by theTitmus test was 61 seconds of arc and 56 seconds of arc by the TNO test. For the 12 adults in the study, corresponding mean stereoacuities were 45 and 31 seconds of arc. Over the same timespan, binocular enhancement of the VEP P100 amplitude decreased. For the children aged 5 to 10 years, the mean binocular VEP enhancement to 20' checks was 1.60, whereas for young adults it was 1.1 9. There was no comparable change in the binocular enhancement to 40' checks, with mean binocular enhancement of 1.31 in the children and 1 .26 in the young adults. Over the same age range, VEP latency also decreased.
Conclusion: During visual maturation, improvement in stereoacuity is accompanied by a fall in binocular enhancement of the P100 amplitude of the VEP to small checks and a reduction in the P100 latency.
Outcome of Occlusion Treatment for Amblyopia
Authors: Beardsell Ruth , Clarke Suzanne , Hill Mary 
Published: April 2021

ABSTRACT
Background The purpose of this study was to determine the level of visual acuity following occlusion treatment for strabismic and anlsometropic amblyopia and to analyze the factors that influence the outcome.
Methods: In this observational study, we examined the medical records of 246 patients discharged between April 1991 and March 1996, including those who failed to complete treatment. Two groups were identified: Group 1 esotropia (n=151); and Group 2 anlsometropic amblyopia with or without microtropia (n=79). Factors influencing outcome of treatment were analyzed, success being defined as 6/12 or better in the amblyopic eye.
Results: In Group 1, 85% achieved 6/12 or better in the worst eye (linear acuity test), 15% achieved less than 6/12. (73% achieved 6/9 or better, 16% achieved 6/12 or 6/18, and 11% achieved less than 6/18). In Group 2, 95% achieved 6/9 or better in the worst eye (linear acuity test); 5% achieved 6/1 2.
Conclusion: Outcome was better than other full population studies to date. A good visual outcome was achieved in all cases of pure anisometropic amblyopia. Significant factors Influencing outcome in the esotropie group were compliance, anisometropia, and visual acuity at start of treatment An occlusion protocol is suggested aimed at further improving compliance and outcome.
Visual Acuities After Levodopa Administration in Amblyopia
Authors: Mohan Kanwar , Dhankar Vandana , Sharma Ashok 
Published: April 2021

Abstract
Purpose: To investigate the effect of the augmentation of levodopa with part-time and full-time occlusion on visual acuity and to determine its late results in amblyopia.
Methods: Seventy-two patients with amblyopia were prospectively studied and randomly distributed into groups A, B, and C consisting of 24 patients each. Group A patients received levodopa alone, group B received levodopa and part-time (3 hours/day) occlusion, and group C received levodopa and full-time (during all waking hours) occlusion of the dominant eye. Levodopa 0.50 mg/kg body weight, with a 25% fixed dose combination of carbidopa, was administered orally three times a day for 7 weeks. Snellen visual acuity and its logMAR equivalent were recorded before treatment, at weeks 1,3, 5, and 7 after starting treatment, and every 6 weeks for 1 year after the completion of treatment.
Results: Fifty-three (74%) of the 72 patients had an improvement in visual acuity after treatment. Forty-four of the 53 patients with improved visual acuities completed 1-year post-treatment follow-up. Twenty-three (52%) of the 44 patients had a regression in visual acuity.
Conclusion: The augmentation of levodopa with parttime or full-time occlusion does not enhance the recovery of vision in amblyopia. Improved visual acuity after levodopa administration persists at least 1 year in almost half of patients after cessation of treatment. Addition of full-time occlusion to levodopa helps maintain improved visual acuity for a longer duration compared to levodopa afone or combined with part-time occlusion.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:62-67.
Effect of Botulinum Toxin A Chemodenervation in Sensory Strabismus
Authors: Han Sueng Han , Lew Helen , Jeong Chang Woog , Lee Jong Bok 
Published: April 2021

ABSTRACT
Purpose: To study the effect of botulinum toxin type A chemodenervation in sensory strabismus.
Methods: Twelve patients with sensory strabismus were treated with an injection of botulinum toxin type A (Botox; Allergan, Irvine, Calif). Botulinum toxin type A was diluted with 0.9% sodium chloride without preservative at a dose that ranged from 1 .25-5 U. A Teflon-coated needle electrode was inserted into the medial reclus muscle in cases of esotropia and into the lateral rectus muscle in cases of exotropia. Four patients were treated with 5=2 injections of botulinum toxin type A. Changes in the angle of strabismus and related complications were followed for >6 months postinjection.
Results: The mean deviation before injection was 33.8 prism diopters (?) and the mean corrective effect on the deviation was 72.8% after injection in patients with sensory strabismus. The final deviation in 9 patients was <10?. Complications were hypertropia in 3 (25%) patients and conjunctival hemorrhage in 1 (8.3%) patient.
Conclusion: Botulinum toxin type A is likely to prevent muscle contracture and affect muscle and neuronal tissues. This study on the effects of sensory strabismus with botulinum toxin type A injection suggests it has the potential to replace surgery or be used as an adjuvant therapy.
Journal of Pediatrie Ophthalmology and Strabismus 2001:38:68-71.
Open Globe Injuries in Children: A Retrospective Analysis
Authors: Farr Arman K , Hairston Richard J , Humayun Michael U , Marsh Marta J , Pieramici Dante J , Maccumber Mathew W , de Juan Eugene 
Published: April 2021

Abstract
Purpose: To study the outcome of open globe injuries In patients aged <14 years and compare the results between patients who presented approximately 30 years ago and a recent series.
Methods: Between January 1970 and January 1993, 180 eyes of children who presented with an open globe injury were retrospectively analyzed. Patients were divided into two groups. One group of children underwent treatment of an open globe injury between January 1970 and December 1981 (group A) and another between December 1985 and January 1993 (group B). Main outcome measures studied were final visual acuity and enucleation rates. Risk factors studied included age, race, sex, visual acuity, type of trauma, and various injury characteristics at presentation.
Results: The factors associated with visual outcomes included: age, type of injury, wound size, initial visual acuity, and retinal detachment. Final visual outcome and enucleation rates were not significantly different between the older series (group A) and the recent series (group B). Lenticular damage, location, posterior extent of the injury, and presence of an intraocular foreign body had been significant prognostic factors in the older series, but were not statistically associated with the prognosis in the recent series.
Conclusion: The nature of the injury and the patient's age are the main determining factors in the outcome of open globe injuries in children.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:72-77.
Effect of Late Surgery for Acquired Esotropia on Visual Evoked Potential
Authors: Kozma Petra , Deák Andrea , Janáky Márta , Benedek György 
Published: April 2021

ABSTRACT
Purpose: To asses the effect of strabismus surgery on visual evoked potential (VEP) amplitude after age 5 years in children with acquired esotropia.
Methods: Visual evoked potentials to binocular and monocular pattern reversal stimulation were recorded in 10 children aged 5 to 6 years before and 3 months after surgical correction of their esotropia. Visual function (fusion) was tested by synoptophore after strabismus surgery. Electrophysiological and clinical data were correlated following surgical intervention.
Results: A significant increase in pattern VEP amplitudes was noted following strabismus surgery. Visual evoked potential changes were most prominent on binocular stimulation. Binocuiar fusion showed similarly significant improvement after intervention. Postoperative VEP data, however, were not consistently correlated with functional improvement.
Conclusion: Surgical intervention in esotropia, even if performed years beyond the end of the classical critical period, can have a strong effect on binocular VEPs and a beneficial effect on the development of binocular fusion.
Journal of Pediatric Ophthalmology and Strabismus 2001 ;38:83-88.
Effectiveness of Mitomycin C in Reducing Reformation of Adhesions Following Surgery for Restrictive Strabismus
Authors: Mahindrakar Avinash , Tandon Radhika , Menon V , Sharma Pradeep , Khokhar Sudershan 
Published: April 2021

ABSTRACT
Purpose: To evaluate the efficacy of mitomycin C in reducing reformation of adhesions following surgery for restrictive strabismus.
Methods: Sixteen patients with restrictive strabismus resulting from trauma, retinal detachment surgery, and multiple squint surgeries were randomized to either a mitomycin group (8 patients) or a control group (8 patients). Mitomycin C (0.2 mg/mL) was applied intraoperatively for 5 minutes after release of adhesions. Range of passive ductions was scored for comparison. Postoperative follow-up ranged from 3-18 months.
Results: Compared to controls, the mitomycin C group had better range of passive ductions. There were no complications related to the cornea, intraocular pressure, uveitis, or muscle disinsertion in the mitomycin C group.
Conclusion: Intraoperative application of mitomycin C (0.2 mg/mL for 5 minutes) is a safe and effective adjunct to surgery in the treatment of restrictive strabismus.
Journal of Pediatric Ophthalmology and Strabismus 2001;38:131-135.