bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior Shoulder Dislocation Reduction Technique-Revisited
Authors: Zahiri Christopher A , Zahiri Hormoz , Tehrany Fereydun 
Published: April 2021

ABSTRACT
Acute anterior shoulder dislocations are extremely painful conditions that force patients to present to emergency rooms or physicians' offices immediately. The diagnosis usually is established through a careful history and examination, and may be confirmed by appropriate radiography. The immediate treatment objective is to achieve reduction as early as possible, preferably through a closed reduction method with the least discomfort. Current methods of reduction are based on either traction or leverage maneuvers, with each having its own merits and disadvantages. This article, however, revisits the subject by a comprehensive literature review. It addresses obstacles to reduction and reports a closed reduction technique for the acute anterior dislocations of the shoulder that uses both traction and leverage maneuvers simultaneously. In addition, the technique eliminates failing factors of current reduction methods such as the surgeons' weakening or slippery grip when using traction methods. It is expected, by virtue of the method, that it would reduce the chances for complications such as humeral shaft fractures as can occur in leverage maneuvers. This method addresses all potential anatomical and pathological features of acute anterior dislocations of the shoulder to facilitate an earlier and more comfortable reduction.
The Accommodative Portion of Mixed Esotropia
Authors: Raab Edward L 
Published: April 2021

ABSTRACT
This study reports observations on the subsequent course of the accommodative component in 139 patients with mixed esotropia after surgery for the nonaccommodative portion of the deviation. An unexpected finding was the presence of a normal distance/near relationship at the time of operation in 69% of these patients. In 40 cases (29%), the accommodative component subsided during the 1st postoperative year. In the remaining patients, the occurrence rate of improvement at longer intervals was similar to that for patients with pure accommodative esotropia observed in prior studies. Persistence was associated with preoperative spherical equivalent hypermétropie of more than 3.00 diopters, but not with a history of strabismus in close relatives. Accommodative esotropia appears to behave the same in pure and in mixed forms.
Changes in the Visual Field After Photocoagulation or Cryotherapy in Children With Retinopathy of Prematurity
Authors: Takayama S , Tachibana H , Yamamoto M 
Published: April 2021

ABSTRACT
We examined the visual field in 13 children (26 eyes) who had had retinopathy of prematurity for which photocoagulation or cryotherapy was administered more than 10 years previously.
Defects of the visual field observed in the periphery of the temporal side corresponded to the sites of photocoagulation scar formation and to areas severely affected by retinopathy of prematurity. In addition, sensitivity in some patients was reduced over the entire visual field.
It has been established that treatment with photocoagulation and cryotherapy is effective in preventing the progression of retinopathy of prematurity. However, on the basis of our results, we recommend that the use of photocoagulation and cryotherapy be minimized to prevent the progression of visual field defects.
Neodymium:YAG Pupilloplasty in Pediatric Aphakia
Authors: Summers C Gail , Holand Edward J 
Published: April 2021

ABSTRACT
An adequate pupillary aperture is required for accurate ophthalmoscopy and retinoscopy in pediatric aphakia. When pupillary miosis does not respond to pharmacologic dilation, optical iridectomy performed with a vitreous suction-cutting instrument under general anesthesia may be required. We report a 27-month-old aphakic child whose pupillary aperture was enlarged from 1 mm to 3.5 mm with neodymium (Nd):YAG pupilloplasty, following intramuscular sedation with meperidine, promethazine, and chlorpromazine. Removal of the laser chin rest and positioning of the patient on a table with adjustable height facilitated delivery of 140 applications at 2.5 to 4.3 mJ to the pupillary border. Levobunolol 0.5% controlled the transient posttreatment rise in intraocular pressure. We suggest that Nd:YAG pupilloplasty performed with sedation be considered as an alternative to intraocular surgery when pupillary miosis in pediatric aphakia does not respond to dilating agents.
The Diagnosis of Amblyopia in Cross-Fixation
Authors: Dickey Carol F , Metz Henry S , Stewart Susan A , Scott William E 
Published: April 2021

ABSTRACT
Customarily, it is taught that cross-fixation, in a patient with congenital esotropia, obviates the development of amblyopia. However, our clinical experience has shown significant amblyopia in 50% of cross-fixators. In our hands, the diagnosis of amblyopia is made based on the point at which alternation of fixation takes place. By this method, if there is equal visual acuity, alternation will occur at the midline with each eye. If amblyopia exists, the sound eye will continue to follow the target beyond midline, into abduction, before the poorer seeing eye picks up fixation. In order to test the reliability of this method, using Teller acuity cards as the standard, we compared estimates of objective and subjective vision in 25 consecutive patients with congenital esotropia and cross-fixation. Our findings suggest that there may be a significant prevalence of amblyopia in cross- fixating patients and that the point at which alternation of fixation occurs is a reliable means of detecting a difference in visual acuity between the two eyes.
Adenocarcinoma of the Ciliary Epithelium in a 12-Year-Old Black Child
Authors: Margo Curtis E , Brooks H Logan 
Published: April 2021

ABSTRACT
Histopathologic examination of a blind eye from a 12-year-old black girl revealed an unsuspected adenocarcinoma of the nonpigmented ciliary epithelium and evidence of previous penetrating trauma. The association between adenocarcinoma of the ciliary epithelium and ocular trauma has been well documented in elderly patients but not in children. The histopathologic distinction between a pleomorphic adenocarcinoma of the ciliary epithelium and a uveal melanoma may be difficult. Signs of previous penetrating trauma should heighten suspicion of an adenocarcinoma, even in young children.
A New Method for Evaluating Distance Stereo Acuity
Authors: Zanoni Diana , Rosenbaum Arthur L 
Published: April 2021

ABSTRACT
A new standardized method for evaluating distance stereo acuity has been developed, using the graphic capacity of a high-frequency microprocessor and liquid crystal binocular glasses. Images are alternately presented at a frequency of 60 cycles per second to each eye, using synchronized liquid crystal shutter glasses. The amount of disparity in the stereo patterns can be altered to allow a measurement as refined as 15 seconds of arc ("). This instrument is now commercially available as part of the Mentor B-Vat system.*
We evaluated distance Random Dot and Contour circle stereo acuity of 50 normal subjects using this new method and compared these results to conventional Titmus and Randot circles at near. The distance stereo acuity mean results were 139" for the Random Dot test and 41 .1 " for the Contour circles. The near stereo acuity results were 41.8" for the Titmus circles and 27" for the Randot circles. Statistically, the Titmus results at near can be compared to the Contour circles at distance. The distance Random Dot test results demonstrate much less stereoability than the other test. The application of these new distance stereotests will be discussed.
Optic Nerve Coloboma With Cyst: A Case Report and Review
Authors: Wiggins Robert E , von Noorden Gunter K , Boniuk Milton 
Published: April 2021

ABSTRACT
A 7-month-old boy presented with strabismus and proptosis of the left eye. He was found to have bilateral optic nerve colobomas associated with cysts arising from the optic nerve sheath and in communication with the subarachnoid space. The evaluation and management of this entity are discussed.
Ocular Alignment Under General Anesthesia in Congenital Esotropia
Authors: de Molina Alfonso Castanera , Muñoz M Luisa Giner 
Published: April 2021

ABSTRACT
Ocular alignment is usually more divergent in strabismus patients under general anesthesia than in the awake state. Although clinical and anesthetized alignments have been reported to be correlated through the equation A = 0.8P + 30, significant differences in the amount of divergence under anesthesia have been reported between esotropes and exotropes. We found differences in response to general anesthesia in a group of 83 congenital esotropes. The averaged anesthetized alignment pertained to the whole group of 6.2 prism diopters of esotropia, which correlated poorly with the preoperative deviation. Mean anesthetized alignments were similar for any amount of preoperative deviation. Recommendations of intraoperative adjustment of surgery based on the anesthetized position should, in our opinion, be reconsidered and recalculated when treating congenital esotropes. A prediction of surgical results following these recommendations suggested an increase of the undercorrection rate, probably linked to an incorrect identification of normal and anomalous cases to the Apt-Romano test.
Congenital Nasolacrimal Sac Mucocele Associated With Respiratory Distress
Authors: Edmond J C , Keech Ronald V 
Published: April 2021

ABSTRACT
Two newborn infants with mucoceles of the nasolacrimal sac presented with respiratory distress due to mucocele-induced nasal cavity obstruction. Nasolacrimal duct probings were performed and resulted in immediate and permanent relief of respiratory difficulties. This rare complication should be considered in the evaluation of infants with congenital nasolacrimal sac mucocele.
The Fluorescein Disappearance Test (FDT): An Evaluation of Its Use in Infants
Authors: MacEwan Caroline J , Young James D H 
Published: April 2021

ABSTRACT
We report a prospective evaluation of the fluorescein disappearance test (FDT) in the diagnosis of lacrimal outflow obstruction in infants under 1 year of age. In a preliminary study of 80 lacrimal systems, we showed that the FDT is a sensitive (90%) and specific (100%) test in aiding the diagnosis of nasolacrimal obstruction in infants.
In the main study, we examined 288 eyes of 232 children with epiphora. The FDT was abnormal in 237 (82%). Of the remaining 51 eyes, there was a clinical explanation for this in 33 cases (epiblepharon, conjunctivitis, etc). We have found that this simple and reliable test taken in conjunction with clinical examination provides an objective assessment of the lacrimal outflow status of young children.
Combination Cyclopentolate and Phenylephrine for Mydriasis in Premature Infants With Heavily Pigmented Irides
Authors: Khoo Boo-Kian , Koh Adrian , Cheong Pauline , Ho Nai-Kiong 
Published: April 2021

ABSTRACT
Purpose: This study examined whether safe and effective mydriasis can be achieved in premature infants with heavily pigmented irides using combination cyclopentolate 0.2% and phenylephrine 1% eyedrops.
Methods: A prospective, randomized double-blind study was performed to compare combination cyclopentolate 0.2% and phenylephrine 1% eyedrops with triple instillation of tropicamide 0.5% and phenylephrine 2.5%. Twenty-eight consecutive babies with dark irides and birthweight <1600 g referred for screening for retinopathy of prematurity comprised the study population. Infants' eyes were randomly dilated twice with both regimens within a 2-week period. Blood pressure, heart rate, and pupil size were measured.
Results: Good mydriasis was achieved in both groups with no significant differences in pupil size or blood pressure (systolic, diastolic, or mean arterial pressures) over starting baseline values. Pulse rates decelerated below the baseline values in both groups, but these differences were not large.
Conclusion: The single combination eyedrop of cyclopentolate 0.2% and phenylephrine 1% is as effective and safe a mydriatic for infants with dark irides as both tropicamide 0.5% and phenylephrine 2.5%.
Journal of Pediatric Ophthalmology and Strabismus 2000;37:15-20.
Binocular Fixation Pattern and Visual Acuity in Children With Strabismic Amblyopia
Authors: Laws D , Noonan C P , Ward A , Chandna A 
Published: April 2021

ABSTRACT
Background: A prospective study was undertaken to compare the binocular fixation pattern and presence of amblyopia in strabismic children.
Methods: Fifty-three children with manifest strabismus and the ability to cooperate with an optotype acuity test were examined. The binocular fixation pattern and logMAR visual acuity were recorded by separate, masked observers under standardized conditions. The binocular fixation pattern was divided into four grades from alternation to uniocular fixation.
Results: Patients who freely alternated did not have amblyopia, while those who maintained or preferred fixation with a given eye tended to have amblyopia in the nonpreferred eye.
Conclusion: The binocular fixation pattern can be rapidly assessed with minimal equipment and training. These findings confirm the usefulness of a graded assessment of the binocular fixation pattern in the detection of amblyopia.
Journal of Pediatrie Ophthalmology and Strabismus 2000;37:24-28.
Clinical Symptoms and Visual Outcome in Patients With Presumed Congenital Cataract
Authors: Lee Young Chun , Kim Hyun Seung 
Published: April 2021

ABSTRACT
Purpose: To investigate clinical symptoms and visual outcome in patients who had presumed congenital cataract with visual acuity ≥20/200.
Methods: Twenty-nine patients (50 eyes) ranging in age from 5-28 years were included in this study. Congenital cataract was diagnosed by patients' past history, previous medical records, and typical findings of congenital cataract. Inclusion criteria were patients with visual acuity measured by Snellen chart, best corrected visual acuity ≥20/200, and no eye or systemic diseases influencing visual acuity. Seven patients had unilateral cataracts and 22 patients had bilateral cataracts. Cataracts were nuclear in 29 eyes, anterior or posterior subcapsular in 12 eyes, and polar in 7 eyes. All patients underwent lens aspiration or phacoemulsification combined with posterior chamber intraocular lens (PC-IOL) implantation without performing intentional posterior capsulotomy and anterior vitrectomy.
Results: The most common clinical symptom was visual disturbance followed by blurred vision, glare and knitting the brow, strabismus, and leukocoria. Comparison of calculated PC-IOL power showed a more significant myopic shift in unilateral cataract than in bilateral cataract. Postoperative best corrected visual acuity >20/25 was attained in 28 (65.1%) eyes with bilateral cataracts and 1 (14.3%) eye with a unilateral cataract.
Conclusions: Cataract surgery is effective not only in improving visual acuity but also in eliminating clinical symptoms. Delaying cataract surgery in early infancy should be considered to avoid intentional operative procedures in patients with bilateral congenital cataract preserving visual acuity >20/200.
Journal of Pediatric Ophthalmology and Strabismus 2000;37:219-224.
Complications of Ocular Paintball Injuries in Children
Authors: Hargrave Sylvia , Weakley David , Wilson Charles 
Published: April 2021

ABSTRACT
Purpose: To evaluate the ocular complications of paintball injuries in children.
Methods: The clinical course of four children with traumatic ocular paintball injuries was evaluated. All patients underwent a complete ocular examination. Their age, injuries sustained, surgical procedure^) performed, presence of protective eyewear at the time of injury, and final visual outcome was assessed. The presence of directly related anterior and posterior segment abnormalities were also evaluated.
Results: Four boys sustained traumatic paintball injuries. Average patient age was 1 1 .25 years (range: 10-12 years). None of the children were wearing ocular or facial protection at the time of the initial injury. All patients had hyphema and traumatic cataract, and some form of retinal pathology (vitreous hemorrhage, epiretinal membrane, retinal hemorrhage, and choroidal rupture). One child had a partial-thickness corneal laceration that did not require surgical intervention. All other patients underwent ophthalmic surgery. Final visual acuity was 20/30 or better in two patients, and 20/100 or worse in the others. The cause of decreased visual acuity in these children was directly related to macular pathology.
Conclusion: Ocular injuries resulting from paintball impact are often severe and usually occur when the participants are not wearing eye protection or this protection becomes dislodged. Treatment of these injuries is sometimes limited to an attempt to salvage what remains of useful vision. Unfortunately, most of these sports-related injuries could have been prevented If patients wore adequate eye protection when involved in this sport.
Journal of Pediatric Ophthalmology and Strabismus 2000;37:338-343.
Astigmatism in Infancy and Childhood
Authors: Montés-Micó Robert 
Published: April 2021

ABSTRACT
Purpose: To evaluate the prevalence of astigmatism In infancy and childhood In a Spanish population.
Methods: A total of 478 children with astigmatism from Valencia Province, Spain were examined. The patients, ranging in age from 2-1 2 years, were classified into groups according to age. Astigmatism error and axis orientation were determined using noncyclopeglc retlnoscopy over each eye.
Results: The overall prevalence of astigmatism (5=1.00 diopter of cylinder) decreased In relation to increasing age from 44.3% to 5.2%. The prevalence of against-the-rule astigmatism decreased from 61.5% (at 2 years) to 33.4% (at 12 years), with-the-rule astigmatism increased In prevalence from 23.1% (at 2 years) to 66.6% (at 12 years), and oblique astigmatism decreased with age from 15.4% (at 2 years) and 0% (at 12 years).
Conclusion: These results do not vary from those observed in other populations. Factors such as race, nutrition, and environmental condition did not vary from the literature regarding the prevalence of astigmatism in infants and children.
Journal of Pediatric Ophthalmology and Strabismus 2000;37:349-353.
The Impact of the Number of Young Adults on an Inpatient Psychiatric Unit
Authors: Lepage James P , Hatton Florence , Pollard Scott , VanHorn Linda , Coffield Patty , McGhee Melanie 
Published: April 2021

Age has been shown to contribute to aggression in inpatient settings. Studies that examine violence in inpatient settings have shown that younger patients have a higher tendency of aggressive behavior toward staff and other patients (Aquilina, 1991; Hillbrand, Foster, & Spitz, 1996; James, Fineberg, Shah, & Priest, 1990; Nijman, Allerti, Merckelbach, a Campo, & Rovelli, 1997; Owen, Tarantello, Jones, & Tennant, 1998).
However, though younger age has been associated with higher rates of violence, no studies have been conducted to assess the impact of multiple young adults on the functioning of an inpatient unit. This study evaluates the effect of the number of young adults on unit functioning and whether young adults mix poorly with other age groups.
Traumatic Corneal Abrasions Following Photorefractive Keratectomy
Authors: Salz James J 
Published: April 2021

ABSTRACT
BACKGROUND: During excimer laser photorefractive keratectomy, central Bowman's layer and superficial stroma are removed. A potential disadvantage of this technique is whether proper epithelization of the cornea will occur in the event of a corneal abrasion. A potential advantage of photorefractive keratectomy over radial keratotomy in the event of blunt trauma is the presumably sound structural integrity of the cornea following superficial removal of stroma in photorefractive keratectomy compared to the weakened cornea following deep incisions in radial keratotomy.
METHODS: We report two patients who sustained corneal abrasions from blunt trauma to the eye and orbit following photorefractive keratectomyone following a fist injury and the other following a karate kick.
RESULTS: In both patients, the corneal abrasions healed without incident and without recurrent erosions and both corneas remained intact.
CONCLUSIONS: Corneal abrasion following trauma in two patients who has undergone photorefractive keratectomy healed as expected in a normal cornea. Although it is uncertain whether the trauma in these patients would have been sufficient to rupture radial keratotomy incisions, as would be expected from a superficial photorefractive keratectomy, the corneas remained intact following blunt trauma. [Refract Corneal Surg. 1994;10:36-37.)
The Learning Curve in Myopic Photorefractive Keratectomy
Authors: Tavola Alessandra , Carones Francesco , Galli Laura , Fontanella Giovanni , Brancato Rosario 
Published: April 2021

ABSTRACT
BACKGROUND: The aim of this study was to assess the role of surgeons' skill on the final results of photorefractive keratectomy (PRK) in the correction of myopia.
METHODS: We evaluated the results of 160 consecutive unilateral treatments performed by four surgeons in a multicenter study group, with a one year follow up. Eighty-eight patients were males (55%) and 72 females (45%). Mean age was 33.7 years (median = 33, standard deviation = 10.22, range 18-65). Attempted correction ranged between -1.50 and -15.00 D. All the eyes received topical corticosteroid therapy postoperatively. At the one year follow up, we evaluated the following: uncorrected visual acuity lines gained and refractive error (spherical equivalent) as parameters of efficacy and predictability; best spectacle corrected visual acuity loss and corneal clarity as safety parameters. We also examined the centration or decentration of the ablation zone. In order to draw up a kind of learning curve, the mean values for each parameter were calculated by arbitrarily grouping the first 10 cases of each surgeon in the first group (40 patients), the second 10 cases in the second group (40 patients) and so on.
RESULTS: We found that increase in uncorrected visual acuity, final refractive error and corneal clarity appeared to improve as the surgeon became more experienced, while loss of best spectacle corrected visual acuity was not significantly influenced by increased surgical experience.
CONCLUSIONS: We think experience with photorefractive keratectomy in at least 40 eyes is necessary to obtain best results. [J Refract Corneal Surg. 1994;10:S188-S193.|
Energy Fluctuations in an Excimer Laser During Photorefractive Keratectomy
Authors: Poirier Laurent , Coulon Pierre , Williamson Wilfrid , Verin Philippe 
Published: April 2021

ABSTRACT
We performed an experiment with the MEL 60 excimer laser (Aesculap Meditee Technology) to demonstrate the variations of energy of the laser beam that could happen during a refractive surgical procedure. In order to quantify such variations, we measured the whitening of a photographic paper after a series of exposures to the laser beam with the X rite 400 BAV reflection densitometer.
The energy fluctuations noted between two series of pulses averaged 11.02% (minimum 0; maximum 46). These fluctuations tended to decrease progressively during the procedure. The energy of the laser beam decreased with time. At the end of the experiment, the total loss of energy was 45.16%.
These results suggest that clinically meaningful energy variations could happen during the photorefractive keratectomy and reduce refractive predictability. |J Refract Corneal Surg. 1994;10:S258S261.1