bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ocular Findings in the Velo-cardio-facial Syndrome
Authors: Mansour Ahmad M , Goldberg Rosalie B , Wang Frederick M , Shprintzen Robert J 
Published: April 2021

ABSTRACTVelo-cardio-facial syndrome is a common genetic syndrome of cleft palate, learning disability, heart disease, and abnormal facial appearance. Ocular findings include retinal vascular tortuosity, posterior embryotoxon, narrow palpebral fissures, suborbital discoloration, small optic nerves, iris nodules, and cataracts. Retinal vascular tortuosity was found to be associated intrinsically with the syndrome and not secondary to the heart disease. The ocular and systemic findings suggest a primary developmental anomaly of neural crest derivatives in the pathogenesis of the syndrome.
The Use of Two-Stage Molteno Implants in Developmental Glaucoma
Authors: Billson Frank , Thomas Ravi , Aylward William 
Published: April 2021

ABSTRACT
Developmental glaucoma, which cannot be controlled by conventional techniques, poses a difficult problem. Twenty-three eyes of 18 patients with developmental glaucoma underwent a two-stage implantation of the double template Molteno valve with follow-up between 12 and 84 months. The final pressure with medication was less than 21 mm Hg in 78% of the cases. These results were obtained in four out of four eyes with primary congenital glaucoma, six out of eight eyes with secondary congenital glaucoma, and eight of 11 eyes in which glaucoma followed surgery for congenital cataract. We feel that two-stage implantation of Molteno valves has a place in the management of difficult developmental glaucomas and is a reasonable early option when glaucoma occurs following surgery for congenital cataract.
One Versus Two Simultaneous Goniotomies as the Initial Surgical Procedure for Primary Infantile Glaucoma
Authors: Catalano Robert A , King Robert A , Calhoun Joseph H , Sargent Robert A 
Published: April 2021

ABSTRACT
To evaluate whether a more extensive Incision of the tissue adjacent to the anterior trabecular meshwork resulted in more effective control of intraocular pressure (IOP), seven infants with bilateral congenital glaucoma underwent a single goniotomy in one eye and two simultaneous goniotomies at separate sites in the second. Sodium hyaluronate (Healon8) was used in all eyes undergoing two simultaneous goniotomies and in three to seven eyes undergoing a single goniotomy. Success was not significantly different, at 1 month or 1 year postoperatively, for eyes which underwent two simultaneous and separate goniotomies. Successful control of IOP was, however, related to the preoperative IOP. Eyes for which the initial procedure was unsuccessful had a significantly higher IOP. The incidence of postoperative hyphemas was less in eyes in which the Healon was used intraoperati vely, but the use of Healon did not favorably or adversely affect intraocular pressure control.
A Hemorrhagic Form of Zone I Retinopathy of Prematurity
Authors: Bachynski B N , Kincaid M C , Nussbaum J , Green W R 
Published: April 2021

ABSTRACT
A premature infant who had vascularized only Zone I developed bilateral progressive hemorrhaging in the posterior poles. Subsequently, vitreous hemorrhages and retinal detachments occurred without any progression through Stages I, II, or III of retinopathy of prematurity. This clinical presentation has not been reported previously. These findings suggest profound underlying abnormalities of funduscopically normal Zone I retinal vasculature. Pathologic findings were consistent with end-stage retinopathy of prematurity.
Unilateral Congenital Cataract: Binocular Status After Treatment
Authors: Pratt-Johnson J A , Tillson G 
Published: April 2021

ABSTRACT
We describe the binocular status of four patients, aged 5, 6, 10, and 13 years, who had a unilateral congenital cataract removed in the first few months of life. A contact lens had been fitted in all cases and was worn continuously. The normal eye was occluded for approximately 90% of the waking day until at least the age of 4 years. Two patients developed an esotropia and two an exotropia. Best-corrected visual acuity is 20/40 or better in both the aphakic and the normal eye.
The patients' binocular status was assessed with a full eye examination, tests for fusion in free space with prism neutralization, tests for stereopsis, and examination on the Clement Clarke Synoptophore. All patients showed simultaneous perception but no real fusion, resulting in diplopia. A vertical bobbing effect was noted at the angle of neutralization similar to that reported by us in cases of central fusion disruption.
The Use of Part-time Occlusion for Early Onset Unilateral Exotropia
Authors: Freeman Richard S , Isenberg Sherwin J 
Published: April 2021

ABSTRACT
Eleven patients (9 months to 5 years of age) with intermittent or constant exotropia of predominantly one eye on distant gaze were studied to investigate the effect of part-time occlusion. No patient had constant exotropia on near fixation. Visual acuity was found to be equal in both eyes. All patients were treated by part-time patching of the non-deviating eye from four to six hours a day and tapered as appropriate. If exotropia recurred after conversion to a heterophoria, part-time occlusion was reinstated.
With occlusion, all patients converted to hetero- or orthophoria, at least temporarily. Mean follow-up (to last visit or surgical Intervention) was 22 months (range 3 to 37 months). Three patients (27%) later developed constant exotropia (mean 28.3 months after beginning occlusion) and underwent surgery. Three patients (27%) became and remain Orthophorie without further patching.
Part-time occlusion for preschool patients with exodeviations that are predominantly unilateral can postpone surgical intervention and convert exotropia to orthophoria or exophoria.
Neural Misdirection in Congenital Ocular Fibrosis Syndrome: Implications and Pathogenesis
Authors: Brodsky Michael C , Pollock Stephen C , Buckley Edward G 
Published: April 2021

ABSTRACT
A child with congenital ocular fibrosis syndrome and oculocutaneous albinism displayed two distinct neural misdirection syndromes: synergistic divergence and Marcus Gunn jaw winking. This and other reported cases of misdirected innervation in patients with congenital fibrosis syndrome suggest that normal neuronal connections fail to become established early in development and that lack of innervation may underlie the pathologic features of the disorder. The prevailing concept of congenital fibrosis syndrome as a primary myopathy should be reconsidered.
Long-Term Results of Bifocal Therapy for Accommodative Esotropia
Authors: Ludwig Irene H , Parks Marshall M , Getson Pamela R 
Published: April 2021

ABSTRACT
We studied the long-term course of 65 accommodative esotropes who required bifocals to maintain alignment at near. Average follow-up was 10.5 years. Forty patients (61.5%, group DC[bifocals discontinued]) were able to discontinue bifocal use after an average of 5.5 years wear. Twenty-five (38.5%) continued to wear bifocals (or a suitable alternative such as reading glasses), after an average 9.7 years of follow-up. Surgical correction of deteriorated accommodative esotropia was performed for 20 patients (50%) in group DC, and nine (36%) of those in group Cfbifocals continued]. Surgery produced an average reduction in the accommodative convergence relationship (near esodeviation in prism diopters [pd] minus corrected distance measurement, AC/A) of approximately 10 pd in both groups. Surgical patients unable to discontinue bifocal wear began with a clinically higher AC/A than those in group DC. Non-surgical patients in group DC experienced spontaneous improvement of the AC/A over time (average, 6.2 pd). On average, this did not occur in those of group C. Average age of bifocal discontinuation was 9.7 years in surgical patients and 9.3 years in the non-surgical. Surgical patients had significantly lower hyperopia ( + 2.4 diopters [D]), than non-surgical (+3.5 D), and an earlier age of onset of bifocal wear (3.29 versus 4.64 years). Although bifocals may be successfully discontinued in a majority of patients at an average age of 9.5 years, a significant percentage require long-term wear, some, despite surgery. The only factor that predicted long-term bifocal wear was a relatively high AC/A.
Follow up Retrospective Study of Compliance With a Standard of Care for Retinopathy of Prematurity in One Neonatal Intensive Care Unit
Authors: Trainor Susan , White George L , Kivlin Jane D , Thiese Steven M , Trunnell Eric 
Published: April 2021

ABSTRACT
A retrospective chart review was conducted to determine the impact of recently instituted guidelines on compliance with the standard of care for retinopathy of prematurity (ROP) in the Newborn Intensive Care Unit at the University of Utah Medical Center. In a previous study, it was found that infants eligible for participation in a National Institutes of Health-funded study of ROP were routinely receiving screening eye examinations, whereas infants who qualified for ROP screening according to the standard of care, but not eligible for the study, were seen infrequently. Consequently, a plan to improve the compliance with the standard of care for all infants who fit the standard criteria was implemented. The comparison revealed significant improvement in compliance rates. In one subgrouping of infants, compliance rose from three of 16 (18.75%) infants screened for ROP according to the standard of care, to nine of 11 (82%) infants screened for ROP according to the revised standard. This increase in compliance appears to be due to adherence to guidelines recommended in an earlier study, which included increasing staff awareness of the standard of care, designating a person to schedule and track infants who fit the screening criteria, and including the need for ROP screening on the admission and discharge summary.
Visual Impairment in a Case of Juvenile Paget's Disease With Pseudoxanthoma Elasticum: An Eleven Year Follow Up
Authors: Sharif Khaled W , Doig William W , Kinsella Frank P 
Published: April 2021

ABSTRACT
An 11-year follow-up of a child presenting with Pagets disease of bone, and who subsequently developed pseudoxanthoma elasticum, is described. The influence of therapy on the ocular manifestations was disappointing. Calcitonin did not prevent the occurrence or progression of angioid streaks, and Argon laser photocoagulation of complicating subretinal neovascular membranes failed to prevent visual loss.
Transformation of Corneal Epithelial Cyst Into Anterior Chamber Implantation Cyst and Scleral Cyst: A Rare Occurrence
Authors: Avni I , Cahane W , Blumenthal M , Naveh N 
Published: April 2021

ABSTRACT
An 8-year-old boy underwent a penetrating keratoplasty for a corneal epithelial cyst. After surgery an anterior chamber implantation cyst appeared. Repeated Neodymium:YAG (Nd:YAG) laser treatments failed to eradicate this cyst; it later extended into the sclera together with the collapse of the anterior chamber cyst. The possible mechanism underlying the development of these cysts is discussed.
Preservation of Anterior Ciliary Vessels During Strabismus Surgery: A Nonmicroscopic Technique
Authors: Freedman Howard L , Waltman Dennis D , Patterson James H 
Published: April 2021

ABSTRACT
Preservation of anterior ciliary vessels (ACVs) during strabismus surgery using microscopic dissection techniques and the operating microscope has been previously described. We describe a technique using standard loupe magnification for vessel preservation, in 77 patients, ages 7 months to 69 years, who had surgery between January 1989 and September 1990. ACVs, with a small sheath of connective tissue, were dissected off the surface of the muscles and tendons using blunt and sharp dissection with Knapp iris hooks and Vannas scissors. Key elements of the dissection were sufficient separation of the vessel complex from the anterior tendon insertion and the use of blunt rather than sharp dissection.
We successfully preserved 125 ACVs in 97 muscles. Ninety-five vessels were saved with 71 recessions, 14 with 13 resections, and 16 with adjustable sutures. The success rate of surgery was 85% in surgeries done either with or without anterior ciliary preservation. Vessel dissection time averaged 5 to 10 minutes per muscle.
ACV preservation can be easily and successfully performed in routine strabismus cases. The procedure does not require the operating microscope and can be done under standard loupe (1.5 to 3.0 x) magnification. This procedure theoretically reduces the risk of anterior segment ischemia in situations where the patient is thought to be at significant risk for this complication.
Late Presentation of Congenital Ectropion of the Eyelids in a Child With Down Syndrome: A Case Report and Review of the Literature
Authors: Sellar P William , Bryars John H , Archer Desmond B 
Published: April 2021

ABSTRACT
Congenital eversión or ectropion of the upper eyelids is rare. Only 50 cases have been reported since the condition was first described in 1896. We encountered an additional case of congenital ectropion of the eyelids, which Is also unusual because of its late presentation for treatment. This case demonstrates the unfavorable outcome of failure to treat this condition at birth and Illustrates the association with Down syndrome. Our case is compared with the others reported in the literature.
Endophthalmitis Following Pediatric Intraocular Surgery for Congenital Cataracts and Congenital Glaucoma
Authors: Wheeler David T , Stager David R , Weakley David R 
Published: April 2021

ABSTRACT
The incidence of endophthalmitis following pediatric anterior segment surgery is currently unknown. The paucity of reports of this entity has led some observers to recommend simultaneous bilateral surgery for congenital cataracts or glaucoma. In this study, we surveyed over 500 pediatric ophthalmologists and glaucoma specialists concerning their knowledge of, or involvement with, endophthalmitis following pediatric intraocular surgery. Seventeen cases of endophthalmitis were documented to occur out of 24 000 reported surgical cases. This results in an incidence estimate of 0.071%, or 7 cases per 10 000, which is similar to that recently reported following adult extracapsular cataract extraction.
The presence of infection was diagnosed by the 3rd postoperative day in 82% of cases. An organism was documented by culture in 65% of cases. The organism was gram positive in all cases.
Visual outcome was generally poor with 65% having no light perception.
The presence of possible concurrent risk factors for postoperative endophthalmitis, including nasolacrimal duct obstruction and upper respiratory infection, was noted in 8 of the 17 cases.
Hypertropia Following Trochlear Trauma
Authors: Legge Richard H , Hedges Thomas R , Anderson Mary , Reese P David 
Published: April 2021

ABSTRACT
Hypertropia following trauma to the trochlea is rare. The more widely recognized response of the trochlea to trauma is hypotropia or acquired Brown syndrome. We observed three cases of hypertropia following penetrating trauma to the trochlea. Each had computerized tomography and/or magnetic resonance imaging to assist in the understanding of the mechanism of the observed superior oblique dysfunction. The clinical course of these cases was variable. Awareness of the damaged trochlea's capacity to respond as a hypertropic as well as a hypotropic syndrome will allow for improved management of these unusual patients.
Results of Combined Surgery on the Superior Oblique and Horizontal Rectus Muscles for A-Pattern Horizontal Strabismus
Authors: Shuey Thomas F , Parks Marshall M , Friendly David S 
Published: April 2021

ABSTRACT
Results obtained in 32 patients with ?-pattern horizontal strabismus and overacting superior oblique muscles treated with combined bilateral superior oblique tenotomies and bilateral symmetric surgery on the horizontal rectus muscles were analyzed retrospectively. The magnitude of reduction of the ?-pattern correlated positively (r = 0.69) with the size of the preoperative A-pattern. Overall, 27 of the 32 patients (84%) had a satisfactory reduction in their ?-pattern. Esodeviated patients received less correction in the primary position than exodeviated patients. Postoperative complications were minimal if the superior oblique tendon was hooked under direct visualization, and minimal dissection was performed on the surrounding tissue prior to transecting it near the nasal side of the superior rectus muscle.
Factors Affecting Long-Term Results of Successfully Treated Amblyopia: Age at Beginning of Treatment and Age at Cessation of Monitoring
Authors: Levartovsky Shmuel , Gottesman Nava , Shimshoni Michael , Oliver Moshe 
Published: April 2021

ABSTRACT
The visual acuity of 104 patients who had previously been successfully treated for unilateral amblyopia by occlusion of the good eye was examined 6.4 years, on average, after cessation of treatment. Three age groups were defined, according to the age at which treatment was started: younger (2 to 5.5 years), middle (5.5 to 8 years) and older (above 8 years). In 55% of the patients, the long-term follow-up examination revealed deterioration of the visual acuity. In patients in whom amblyopia had been monitored at least up to the age of 9 years, the age at which treatment was started did not significantly affect the mean amount of deterioration or the mean visual acuity noted at the long-term follow-up examination.
Aplasia of the Optic Nerve: Report of Three Cases
Authors: Blanco Roman , Salvador Francisco , Galan Alicia , Gil-Gibernau Juan J 
Published: April 2021

ABSTRACT
Aplasia of the optic nerve is a very rare congenital anomaly characterized by an absence of optic nerve fibers, retinal ganglion cells, and the retinal central blood vessels. It may be associated with a wide range of other congenital abnormalities. In the present article, three cases of aplasia of the optic nerve are described. Its pathology and clinical features are reviewed.
Comparison of On- and Off-Axis Photorefraction With Cycloplegic Retinoscopy in Infants
Authors: Hamer Russell D , Norcia Anthony M , Day Susan H , Haegerstrom-Portnoy Gunilla , Lewis Derf , Hsu-Winges Charlene 
Published: April 2021

ABSTRACT
We have compared the performance of an off-axis (knife-edge) photorefractor with that of an on-axis (isotropic) system. Normal infants and children between the ages of 8 and 208 weeks were photographed with each camera both with and without cycloplegia. Refractive errors were estimated for each technique based on equations derived from ray-tracing. These refractions were compared to the results of retinoscopy under cycloplegia.
Sensitivity and specificity of the two photorefraction systems were evaluated as a function of the magnitude of meridional hyperopia defined by retinoscopy. We also examined the effect of varying the photorefraction screening criterion.
Thirteen percent of the infants in the screening sample presented with +3.50 diopters or more of meridional hyperopia. Using this level of ametropia as a referral criterion, the sensitivity and specificity of the off-axis system for infants without cycloplegia were 83% and 72%, respectively. For the on-axis system, sensitivity and specificity values were 85% and 53%. The use of cycloplegics did not significantly improve the performance of either system, but rather their use degraded the specificity of the on-axis system in the presence of moderate refractive errors. The results of the present study indicate that both on- and off-axis systems are effective in identifying highly ametropic infants, but that the off-axis system results in significantly fewer false positives. Moreover, the off-axis system has the advantages of an inherently greater dynamic range for a fixed camera design, and also more easily interpreted photographs.
Changes in Eyelid Position Accompanying Vertical Rectus Muscle Surgery and Prevention of Lower Lid Retraction With Adjustable Surgery
Authors: Pacheco Elba M , Guyton David L , Repka Michael X 
Published: April 2021

ABSTRACT
Whether or not eyelid position changes are caused by vertical rectus muscle surgery is controversial and poorly understood. We reviewed pre- and postoperative photographs of patients who underwent recession or resection of one or more vertical rectus muscles in a 10-year period. A change in eyelid position occurred frequently with vertical rectus muscle surgery. With superior rectus recession, 91% of the patients developed upper lid retraction. With inferior rectus recession, 94% of patients developed lower lid retraction. With inferior rectus resection, every patient developed lower lid advancement with accompanying flattening.
We describe an adjustable surgical technique to prevent lower Md retraction associated with inferior rectus recession. The technique involves a separate adjustable suspension of the lower eyelid retractors from the inferior rectus insertion at the time of strabismus surgery. The lid position can then be adjusted separately at the time of muscle adjustment. After an average 21/2-month follow up, no statistically significant lid retraction could be measured in six patients who underwent the adjustable lid suspension, while statistically significant retraction (P < .01) developed in a group of nine patients who had inferior rectus recession alone. This technique did not limit the success of the strabismus surgery.
Cloudy Lenses and Issues: A Pedigree of Unoperated Congenital Cataracts
Authors: Freeman Richard S , Rovick Lisa P 
Published: April 2021

ABSTRACT
The issue of when congenital cataracts should be removed seems to be well resolved, with most recommendations stating that all significant central lens opacities should be removed by 4 months of age, with removal most commonly occurring the first month. Although there are many strong recommendations regarding congenital cataracts in the literature, little has been written about the initial decision of whether or not to operate.
A pedigree is presented of multiple generations with inherited bilateral central cataracts. Two affected children, who did not undergo surgery, were followed from birth. These two children developed essentially normal vision, despite seemingly significant central opacities. This pedigree emphasizes the need to further examine prognostic factors regarding bilateral infantile cataracts and to analyze the initial surgical decision.
Because this condition does not often occur and a large number of patients is necessary to determine the predictive value, a large, collaborative study is required to make significant headway in this area. If we can identify the factors that have strong predictive value for good vision after cataract surgery, we may start to define the profile of children who will have good vision, with or without surgery.