bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ankyloblepharon Filiforme Adnatum in Trisomy 18
Authors: Bacal Darron A , Nelson Leonard B , Zackai Elaine H , Lavrich Judith B , Kousseff Boris G , McDonald-McGinn Donna 
Published: April 2021

ABSTRACT
Ankyloblepharon filiforme adnatum (AFA) is a mild form of ankyloblepharon, in which there is partial thickness fusion of the central portion of the Hd margins, sparing the canthi. Although it can be seen as an isolated sporadic congenital defect, it is important for pediatric ophthalmologists to be cognizant of its possible association with a number of anomalies. One infrequent, but nevertheless important association, is with trisomy 18. We present three cases of AFA in association with trisomy 18, and emphasize the need for clinicians to search for other abnormalities in a newborn presenting with AFA.
Incomplete Presentations in a Series of 37 Children With Kawasaki Disease: The Role of the Pediatric Ophthalmologist
Authors: Blatt Andrew N , Vogler Lawrence , Tychsen Lawrence 
Published: April 2021

ABSTRACT
Background: Kawasaki disease (KD) is an acute and sometimes fatal febrile vasculitis of childhood, the presenting signs of which include conjunctival vessel dilatation and iridocyclitis. Consultation with a pediatric ophthalmologist is helpful for early recognition of the disease, especially In identifying "incomplete" cases, ie, those which lack all of the classical, systemic signs.
Methods: After encountering a case of incomplete KD in which diagnosis was delayed, we reviewed the hospital records of 37 children with KD to establish how often the disease manifested "incompletely," and how often pediatricians consulted pediatric ophthalmologists to help in its early diagnosis.
Results: Forty-five percent of the children eventually diagnosed with KD lacked the complete diagnostic criteria of KD when admitted to the hospital, and diagnosis and treatment therefore were delayed. Coronary artery aneurysms, a complication that might have less serious consequences if treated earlier, developed in 24% of these patients. Although 67% presented to their pediatrician with bilateral conjunctival injection and/or iridocyclitis, pediatricians requested ophthalmologic consultation for only 5% of them.
Conclusions: Our review of these cases indicates that the eye findings in KD could play a role in earlier diagnosis and treatment. Pediatric ophthalmologists and pediatricians should be more aware of their combined responsibilities for expethent recognition of KD.
Polaroid Scotometer: A New Device to Chart Suppression Scotomata
Authors: Prakash Prem , Sharma Pradeep , Rao V Madhav , Shastry Prabhakar , Menon Vimala 
Published: April 2021

ABSTRACT
Suppression, an active inhibition of vision in one eye under binocular conditions, is a sensory adaptation in concomitant strabismus. The characteristics and extent of suppression differ not only in different types of strabismus but also in the same type under different testing conditions, which may differ in their degree of dissociation. The findings in exodeviations have thus varied from regional suppression to hemiretinal trigger, and in esodeviations from two point scotoma to single large scotoma. There is a need for a simple but less dissociative test to chart the fields under binocular conditions. We have devised a new, simple instrument based on polaroid dissociation. The findings corroborate the findings of more sophisticated tests like phase-difference haploscope.
Surgical Implications of the Rectus Extraocular Muscle Pulleys
Authors: Demer Joseph L , Miller Joel M , Poukens Vadims 
Published: April 2021

ABSTRACT
Purpose: Magnetic resonance imaging (MRI) shows that the paths of rectus extraocular muscle bellies remain fixed in the orbit during large ocular rotations, and across large surgical transpositions of their insertions. This stability of muscle paths is due to their passage through pulleys which are coupled to the orbit and located in a coronal plane anterior to the muscle bellies near the equator of the globe. Autopsy studies have shown the pulleys to be fibroelastic sleeves consisting of dense bands of collagen and elastin, suspended from the orbit and adjacent extraocular muscle sleeves by bands of similar composition. Immunohistochemical studies have revealed substantial smooth muscle in the pulley suspensions and in posterior Tenon's fascia. The pulleys as mechanical origins of the rectus extraocular muscles in the sense of determining extraocular muscle directusons. This study was conducted to determine the theoretical effects of the pulleys on the outcome rectus transposition surgery.
Methods: The functional and anatomical evidence for existence of the rectus extraocular muscle pulleys reviewed. In two patients, binocular alignment data collected using the Hess screen test before and vertical rectus transposition surgeries for lateral rectus paralysis. Paths of the rectus extraocular muscles determined using high resolution MRI. The Orbit? 1.5 extraocular biosimulation program was employed to theoretical binocular alignment and muscle paths, under alternative conditions including or omitting pulleys.
Results: Pulleys are required to account for observed paths of rectus extraocular muscles following transposisurgery. In the absence of pulleys, transposition of superior and inferior rectus muscles to the lateral rectus insertion for abducens paralysis would result in ocular misalignments not observed clinically.
Conclusions: The human orbit contains specialized musculofibroelastic tissues in and just posterior to fascia, which serve as pulleys, determining of rectus extraocular muscles. These pulleys are located in a roughly coronal plane just posterior to the of the globe. Unimpaired pulley function is to effective muscle transposition surgery.
Conservative Treatment of Congenital Dacryocele
Authors: Schnall Bruce M , Christian Colleen J 
Published: April 2021

ABSTRACT
Purpose: To study prospectively the effectiveness of medical management of congenital dacryoceles.
Methods: All patients presenting with congenital dacryocele that were not infected were treated with warm compresses, massage, and topical antibiotics. Dacryoceles that did not resolve with at least two weeks of medical management were probed. Dacryoceles that were infected were treated with intravenous (IV) antibiotics in addition to warm compresses and massage.
Results: Seventeen patients with 21 dacryoceles were studied over a 3⅓-year period. All patients were examined by the authors and treatment was initiated prior to 3 weeks of age. Sixteen dacryoceles resolved with medical management in 1 to 6 days. Three of these 1 6 dacryoceles were infected and patients were hospitalized at the time of initial ophthalmic evaluation (2 to 4 days of life). One additional dacryocele became infected after 2 days of medical management (4th day of life), requiring hospital admission and IV antibiotics. All four infected dacryoceles resolved within 24 hours of the initiation of IV antibiotics, warm compresses, and massage. Five dacryoceles were probed after not resolving within 14 to 31 days of medical management. One dacryocele required a repeat probing.
Conclusions: Medical management can be effective in the treatment of congenital dacryoceles; 76% of dacryoceles in this series resolved after 6 days of medical management.
Pediatric Devic's Neuromyelitis Optica
Authors: Jeffery Amy R , Buncic J Raymond 
Published: April 2021

ABSTRACT
Purpose: Neuromyelitis optica (Devic's disease) is a rare clinical syndrome of unilateral or bilateral optic neuritis (ON) and transverse myelitis (TM) occurring within an 8-week time interval. All reports mainly involve adults and describe a poor neurologic and ophthalmic clinical course without specific attention to their few pediatric cases. The purpose of this study was to develop a clinical profile in the pediatric population.
Methods: A retrospective chart review over 15 years revealed nine cases of neuromyelitis optica. A literature search was undertaken and all cases of pediatric neuromyelitis optica were tabulated and analyzed separately.
Results: The average age of onset was 7 years with a preceding viral prodrome in all patients. The optic neuritis was bilateral in eight of nine patients (89%). Visual loss ranged from 20/30 to light perception. Moderate anterior disc edema was seen in all 17 affected eyes. The clinical course was characterized by a rapid visual and neurologic recovery. The average follow up was 5.3 years, with five patients followed for 6 years or longer. None of the nine patients had any visual or neurologic recurrence or other significant subsequent illness. Visual system follow up showed 20/20 in each eye of all patients with mild optic atrophy, identified in 47% of eyes.
Conclusions: Devic's neuromyelitis optica occurs in the pediatric population as a distinct clinical entity with an excellent prognosis for visual and systemic recovery and no future recurrence or long-term sequelae.
B-Scan Ocular Ultrasonography in Preterm and Term Infants
Authors: Isenberg Sherwin J , Fishman Marci 
Published: April 2021

ABSTRACT
Purpose: To evaluate the normal B-scan ocular ultrasonographic findings in preterm and term newborns.This information would be useful in making perinatal ocular diagnoses, especially in consideration of the rapidly changing eyes of normal infants shortly after birth.
Methods: One hundred two healthy infants aged 28 to 48 weeks postconception were prospectively studied. Eighty-six had complete sonograms, while others had incomplete examinations due to systemic instability. Bscan Ultrasonography was conducted through acoustic coupling medium and a closed eyelid using the Coopervision Ultrascan 404 unit. The ultrasound findings were evaluated relative to the infant's post concepii o nal age and weight at examination and the axial lengths of each eye. The ultrasonographer, who determined the presence of abnormal findings, was masked to the parameters mentioned above.
Results: Four specific findings frequently were noted in newborns that would be considered abnormal in adult eyes. These were: 1) a visible Tenon's capsule; 2) prominent superior ophthalmic vein; 3) sonolucent extraocular muscles; and 4) vitreous opacities. These findings were more common in the more premature infants (P-cO.01 by t test).
Conclusions: The presence of these four ultrasonographic findings in the eyes of infants should be considered normal, and should not necessarily prompt further work up until after the perinatal period.
The Modified Frisby Stereotest
Authors: Saunders Kathryn J , Woodhouse J Margaret , Westall Carol A 
Published: April 2021

ABSTRACT
Background: The Frisby stereotest commonly is used in clinical practice to estimate stereoacuity. Assessment of the presence or absence of stereopsis is valuable particularly in toddlers because of the difficulties encountered in this age group with assessment of other aspects of visual function, such as monocular visual acuities.
Methods: The present study describes two modifications to the Frisby stereotest: 1) the introduction of a nonstereo practice plate,- and 2} the use of an auditory "reward" for correct identification of the target. These modifications aim to increase the success rate of the test and provide a means to discriminate between testable and untestable children. Subjects were 165 children aged between 0.5 and 47 months.
Results: The modifications improved the age range over which results could be obtained with the Frisby test, allowing infants as young as 7 months to complete testing. By 12 months of age, more than 60% of children were able to complete testing. The modifications also allowed the examiner to distinguish untestable children from those without stereopsis.
Conclusions: By simple modification of the Frisby stereotest, the authors have increased the ease with which the Frisby stereotest can be used to assess stereoacuity in infants and children and provided a means by which children unable to cooperate with testing can be distinguished from those without stereopsis.
Fundus Morphology Assessed by Digital Image Analysis in Children With Fetal Alcohol Syndrome
Authors: Hellström Ann , Chen Yahua , Strömland Kerstin 
Published: April 2021

ABSTRACT
Background: Fetal alcohol syndrome (FAS) is associated with anomalies of the eye ground. The aim of this study was to evaluate the development of fundus morphology in children with FAS from early childhood to adolescence.
Methods: Fundus photographs were evaluated by digital image analysis in 16 children with FAS. Age at the baseline study was between 0.25 and 14 years, and the median follow-up period was 7 years (range: 0.5 to 12). Sixteen sex- and age-matched healthy children were used as controls.
Results: Children with FAS had a smaller optic disc area, lower frequency of excavations, greater tortuosity of retinal vessels, and a smaller number of vascular branching points compared with the controls. There were no significant differences in the fundus abnormalities between the first and last examinations.
Conclusion: No interval change of retinal fundus morphology was found at follow up, suggesting that the ocular abnormalities associated with FAS remain unchanged during childhood.
Psychosocial Implications of Strabismus Surgery in Adults
Authors: Burke John P , Leach Carolyn M , Davis Helen 
Published: April 2021

ABSTRACT
Purpose: Adults with socially noticeable strabismus have been known to experience psychosocial difficulties as a result of their abnormal eye position. This study was designed to assess the impact of noticeable strabismus in adults and the psychosocial effects of surgical correction.
Methods: A total of 31 adults who underwent surgery for longstanding horizontal strabismus where poor alignment was the primary reason for consenting to surgery were requested to complete a self-reporting repertory grid to appraise the psychosocial consequences of corrective strabismus surgery.
Results: Prior to corrective surgery, the majority of subjects reported various psychosocial difficulties, considered by them to be wholly or partly due to their unsightly strabismus. A significant improvement in interpersonal interactions is apparent following strabismus surgery.
Conclusion: Surgery to improve ocular alignment appears to herald major improvements in the quality of psychosocial functioning for the majority of adults undergoing such surgical procedures (P≤0.001).
Retinal Examinations in Infants After Extracorporeal Membrane Oxygenation
Authors: Varn Mary M , Donahue Margaret L , Saunders Richard A , Baker John D , Smith Craig M , Wilson M Edward 
Published: April 2021

ABSTRACTBackground: Ophthalmic examinations performed in infants undergoing extracorporea I membrane oxygenation (ECMO) are recommended because ocular abnormalities have been known to occur after this procedure.Methods: We reviewed medical records of infants treated with ECMO who subsequently underwent routine ophthalmic examination prior to or immediately after hospital discharge. Examinations were performed in a fashion similar to that for retinopathy of prematurity screening.Results: Eye examinations were recorded for 171 patients (342 eyes). Fundus examination was normal in 302 eyes (88%). Abnormal ret i n ovase u lar findings such as venous dilation or intraretinal hemorrhages, when present, were not considered vision threatening and required no treatment.Conclusion: Clinically important retinal findings were not identified in our patients undergoing postECMO screening. Routine dilated fundus examination is probably not cost effective and places additional and potentially unnecessary stress on these infants.
Effect of Ongoing Treatment of Amblyopia on Surgical Outcome in Esotropia
Authors: Weakley David R , Holland Daniel R 
Published: April 2021

ABSTRACT
Purpose: Classic teaching recommends completion of amblyopia therapy prior to surgical correction of esotropia. Recent reports, however, suggest that incomplete treatment does not adversely affect surgical outcome. This study assesses the effect of incompletely treated amblyopia on the success rate of bimedial rectus recession in infantile and acquired esotropia.
Methods: All patients (n=102) with esotropia undergoing bimedial rectus recession in 1994 who met inclusion criteria were reviewed. Subjects were classified as having infantile; acquired, partially accommodative; or acquired, nonaccommodative esotropia for comparison. Amblyopia was classified as none, mild, moderate, or severe. Surgical success was defined as orthophoria ± 8 prism diopters and was assessed at the second postoperative visit (4 to 6 weeks after surgery). Other variables studied included mean surgical age, preoperative deviation, millimeters of surgery, and amount of follow up.
Results: For all patients, surgical success rates were as follows: no amblyopia, 84.3% (43/51); mild amblyopia, 81.6% (31/38); and moderate amblyopia, 61.5% (8/13). All patients with severe amblyopia underwent unilateral recess/resect procedures and were excluded. Of the esotropia subgroups, a statistically significant decrease in surgical success was noted only in the infantile esotropia group with moderate amblyopia. For this group, success rates were as follows: no amblyopia, 77.1% (27/35); mild amblyopia, 81.0% (17/21); and moderate amblyopia, 16.7% (1/6), ^0.005.
Conclusions: Performing corrective surgery on patients with infantile esotropia leads to poorer surgical outcome if moderate amblyopia is present at the time of surgery. Mild amblyopia, however, does not adversely affect surgical outcome in patients with infantile esotropia. Furthermore, the presence of mild or moderate amblyopia does not appear to have an influence on surgical outcome for patients with acquired esotropia. The effect of amblyopia on sensory outcome was not studied as most patients were too young for reliable sensory testing.
Pediatric IOL Implantation: The KKESH Experience
Authors: Wheeler David T , Mullaney Paul B , Awad Abdulaziz , Al-Mesfer Saleh , Al-Nahdi Talal , Zwaan Johan 
Published: April 2021

ABSTRACT
Background: Intraocular lens (IOL) implantation is increasingly accepted as a means of correcting pediatrie aphakia. However, few large series have been reported. We present our experience over the past 6 years.
Methods: Charts were reviewed of 84 patients (88 eyes) 8 years old or younger who underwent IOL implantation at King Khaled Eye Specialist Hospital between January 1989 and March 1995. An attempt was made to correlate visual outcome with patient variables, and refractive outcome was assessed.
Results: Despite a high percentage of patients with penetrating trauma (24%) and a significant level of poor compliance with amblyopia treatment (33%), one third of patients saw 20/40 or better, and 60% had at least 20/80 acuity. Improved visual outcome correlated with later onset and shorter duration of opacity and compliance with occlusion therapy. The posterior capsule was left intact in the majority of cases; opacification occurred in 47 eyes, 25 of which required Nd: YAG capsulotomy. No unexpected complications occurred. Prediction of postoperative pseudophakic refraction was within 2 diopters (D) in 70% of patients.
Conclusion: IOL implantation in appropriate children can be used as a safe alternative to other methods of correcting pediatrie aphakia. Visual outcome often depends on amblyopia management. These patients are appropriately followed by ophthalmologists who are experienced in managing amblyopia and pediatrie pseudophakia.
Constriction of the Visual Field of Children After Early Visual Deprivation
Authors: Bowering Elizabeth R , Maurer Daphne , Lewis Terri L , Brent Henry P 
Published: April 2021

ABSTRACT
Purpose: We measured the extent of the monocular visual fields of children deprived of normal visual experience and examined the influence of the timing and duration of deprivation, of whether deprivation was monocular or binocular, of having patched the fellow eye, and of optical factors.
Methods: The Goldmann perimeter and a 6.4' stimulus of either 31 .8 cd/m2 (target I2e) or of 318 cd/m2 (target I4e) were used to test 44 children treated for a dense and central cataract in one (n=25) or both (n=31) eyes that developed before 6 years of age. Then, the influence of optical factors was assessed in two adults treated for a lateonset, unilateral cataract and in two children treated for unilateral congenital cataract.
Results: Compared with age norms or the normal fellow eye, all children treated for cataract showed a restricted field, especially temporally, even when deprivation began as late as 6 years of age and lasted less than 6 months. The restrictions were larger than those shown by the adults who developed cataracts. The restrictions were larger after longer deprivation and monocular deprivation than after binocular deprivation. However, children who regularly patched the fellow nondeprived eye and, therefore, experienced less interocular competition, exhibited smaller restrictions temporally. Neither visual acuity nor optical factors could account for all of the restrictions in the deprived children.
Conclusions:The development of the visual field is vulnerable to the effects of deprivation, especially to unilateral deprivation and to long deprivation. The losses likely reflect alterations in the visual pathways subserving peripheral vision.
Assessing Visual Function in Children Younger Than IVz Years With Normal and Subnormal Vision: Evaluation of Methods
Authors: Rydberg Agneta , Ericson Birgit 
Published: April 2021

ABSTRACT
Purpose: Methods for detecting subnormal vision early in life are needed to adequately diagnose the condition and begin treatment and rehabilitation.
Methods: Forty-six children ages 1 month to 1'/2 years with either assumed normal vision, visual impairment due to eye disease, or strabismus were examined with the following tests: Stycar rolling balls; preferential looking (Teller acuity cards); and the ability to detect raisins, puffed rice, and sugar strands on two different backgrounds, one white and one black.
Results: Children with visual impairment and strabismus often showed normal values for their age, and children with assumed normal vision sometimes had values below those established for normal development of vision with the Stycar rolling balls and the Teller acuity cards.
Conclusions: It is not possible to use these tests to reliably differentiate among normal vision, visual impairment, or strabismus in children younger than 1Va. Not until recognition acuity, symbols, or letters can be tested can reliable results be obtained. However, the tests are useful to estimate the general visual function of children in this age group.
Ultrasound Biomicroscopy of the Anterior Segment of the Eyes of Infants
Authors: Kiryu Junichi , Park Masami , Kobayashi Hiroshi , Kondo Takehisa 
Published: April 2021

ABSTRACT
Background: Our objective was to evaluate the new method of ultrasound biomicroscopy in examining the anterior segment of the eyes of infants.
Methods: The infant was held supine during examination, which was performed under topical anesthesia only. One drop of proparaca i ne was placed in the eye, and a small Md speculum was inserted. The palpebrai fissure was filled with 2.5% met hy !cell u lose as a coupling medium. The ocular cup was not used. Scanning was performed by placing the probe close to the area of interest.
Results: Case 1 : A 3230-g male infant was delivered by cesarean section at 39 weeks' gestation. The left eye was studied with ultrasound biomicroscopy. Examination revealed a narrow angle with the anterior chamber angle of 25°. The trabecular-ciliary process distance was 510 µ?t?. The depth of the anterior chamber was 1414 µ??.
Case 2: A 1368-g female infant was delivered by cesarean section at 30 weeks' gestation. The left eye was studied. The anterior chamber angle was 16°. The trabecular-ciliary process distance was 380 µ??. The depth of the anterior chamber was 1134 µ??.
Conclusion: Ultrasound biomicroscopy is clinically feasible in infants and has a potential for use in clinical research. Additional study is needed to assess the reproducibillty of the measurements and to acquire additional clinical experiences.