Journal of Pediatric Ophthalmology and Strabismus This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Impact of a Strabismus Surgery Suture Course for First- and Second-Year Ophthalmology Residents
Competency in surgery of a resident has been described as the ability of the resident to perform a procedure in a reasonable amount of time while achieving the desired outcome without intervention by a supervisor or complications. Complications in strabismus surgery resulting from improper surgical technique include a slipped or lost muscle. Inadvertent tears in Tenon's capsule can result in the prolapse of orbital fat with fat adherence or restrictive strabismus postoperatively. Reattaching a muscle incorrectly may create unexpected torsion or horizontal or vertical deviation. Recognized (Source: Journal of Pediatric Opht...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Aldo Vagge, MD Source Type: research

Traumatic Ruptured Globe From a .22 Cartridge Casing in a 2-Year-Old Girl
We report an unusual mechanism of preventable penetrating ocular trauma and recommend suggestions regarding firearm and ammunition safety and an ophthalmologist's role in educating parents and patients. A 2-year-old previously well girl presented to the emergency department following a .22 caliber cartridge casing injury to her left eye. The patient was playing (Source: Journal of Pediatric Ophthalmology and Strabismus)
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Jacob S. Martin, MD Source Type: research

Surgical Technique for Pulled in Two Syndrome: Three Cases With Chronic Progressive External Ophthalmoplegia
“Pulled in two syndrome” (PITS) is a rare complication of strabismus surgery characterized by rupture of the extraocular muscle under minimal tension and not through inappropriate excess force.1–4 This rare occurrence is described predominantly in cases in which there is preexisting extraocula r muscle pathology, although the muscle can appear macroscopically normal.3,5 Reported risk factors include previous strabismus surgery, extraocular muscle palsy, thyroid eye disease, or metastatic infiltration.6,7 Surgical outcome depends on retrieval of the dehisced muscle, which can be either sutured (Source: Journal of Pedi...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Alexander Matthew Jones, MSc, MA, MB BChir Source Type: research

Surgical Management of Brown Syndrome
Wagner: This session is on surgical management of Brown syndrome. I am going to describe what I consider to be a typical case of Brown syndrome that would end up being a surgical case. A 3-year-old child had unilateral Brown syndrome in the right eye with significant chin-up face position and left face turn. There was a right hypotropia of 6 prism diopters in primary gaze that increased significantly in gaze to the left. There was also an underaction of the elevation in the right eye in the adducted position, as you would expect. The parents believed that the problem was greater in the left (Source: Journal of Pediatric Op...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: James A. Deutsch, MD Source Type: research

Clinical Features and Surgical Outcome of Triad Exotropia
A prevalence of A-pattern strabismus with exotropia is reported in 9% to 27% of exotropia cases.1 –4 Dysfunction of the superior oblique muscle is suggested as the principal cause of horizontal strabismus with A-pattern.3 Superior oblique overaction is an exaggeration of the normal function of the superior oblique muscle that includes intorsion, depression, and abduction. Dissociated vertical deviation is the tendency for an eye to elevate, abduct, and extort when binocularity is suspended by occlusion or the patient spontaneously dissociates. However, causes of dissociated vertical deviation (Source: Journal of Pediatri...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Suk-Gyu Ha, MD Source Type: research

Effect of 4-Month Intermittent Atropine Penalization in Amblyopic Children for Whom Patch Therapy Had Failed
The purpose of amblyopia treatment is to decrease visual stimulus to the sound eye, increase use of the amblyopic eye, and thus improve visual acuity (VA).1 Patch therapy has been the most universally employed method. However, side effects such as local irritation and allergy, impaired binocularity during treatment, and psychological stress due to cosmetic issues can occur.2,3 For patients showing such side effects or poor compliance, alternative therapy must be considered. Alternative therapy is also necessary for patients showing no improvement after 6 months of treatment, which is the (Source: Journal of Pediatric Ophth...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Bo Ram Seol, MD Source Type: research

Correlation Between Clinical Examination and Diagnostic Imaging in Type II Peters Anomaly
A full-term 7-week-old infant presented to a pediatric ophthalmologist for evaluation of a congenital corneal opacity of the left eye. The pregnancy and delivery were uneventful and the infant was otherwise healthy. On clinical ophthalmic examination, visual acuity was grimace to light in both eyes. Examination under anesthesia revealed a central leukoma (Figure 1A) with a corneolenticular adhesion of the affected eye (Figure 1B), which correlated with high-resolution ultrasound imaging (Figure 1C). Gonioscopy showed an anteriorly coned lens with adhesion to the central cornea. The (Source: Journal of Pediatric Ophthalmology and Strabismus)
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: David S. Walton, MD Source Type: research

Medial Rectus Bridge Faden Operations in Accommodative and Partially Accommodative Esotropia With Convergence Excess
Esotropia that is caused by an increased accommodative effort or an abnormally high accommodative convergence –accommodation ratio is referred to as accommodative esotropia. Esotropia is partially accommodative when accommodative factors contribute to but do not account for the entire deviation.1 The surgical course for bilateral medial rectus recession for accommodative and partially accommodative esotro pia is often difficult to determine and undercorrections are common in such patients.2 A Faden operation on the medial rectus muscles with or without recession is the standard procedure used (Source: Journal of Pediatri...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Asli Inal, MD Source Type: research

Video Game Vision Syndrome: A New Clinical Picture in Children?
Many individuals who spend long periods of time at video display terminals report a combination of eye and vision issues.1 –3 According to the American Optometric Association,4 computer vision syndrome is “the complex of eye and vision problems related to near work which are experienced during or related to computer use.” These symptoms are not exclusively connected to work-related tasks,5 but can affect individua ls of all ages due to the widespread use of video display terminals in everyday life.6 It has been recently noted that the use of video games can improve the visual performance of (Source: Journal of Pediat...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Caterina Rechichi, MD Source Type: research

Toward Achieving 100% Adherence for Retinopathy of Prematurity Screening Guidelines
The publication of the policy statement “Screening of Premature Infants for Retinopathy of Prematurity” by the American Academy of Pediatrics (AAP), American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Association of Ophthalmologists in 2013 set the standard for the screening and treatment of retinopathy of prematurity (ROP) in the United States.1 Implementing these guidelines can be a challenge for many reasons, partially due to the complexity of the neonatal intensive care unit (NICU) setting, where pediatric ophthalmologists (Source: Journal of Pediatric Op...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Robert W. Arnold, MD Source Type: research

Three Cases of Associated Persistent Fetal Vasculature and Ocular Coloboma: Posterior Segment Dysgenesis
We present three cases where PFV and choroidal coloboma occurred simultaneously. We discuss the possibility of a cause-effect relationship between these two disorders. A 1-year-old boy presented at Dr. (Source: Journal of Pediatric Ophthalmology and Strabismus)
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Sudarshan Khokhar, MD Source Type: research

Clinical Pearl: The “Rule of 8”
The recording of visual acuity, or clarity of central vision, is among the most critical aspects of the eye evaluation. In children especially, identifying subnormal visual acuity is of utmost importance so that treatment can be initiated promptly. However, determination of visual acuity in the preschool age group can be challenging. Even children with normal ocular and visual pathway anatomy typically perform worse than 20/20 due to non-ocular issues such as concentration, cooperation, and/or confidence. As a result, it is a challenge to know what “normal vision” is in this at-risk (Source: Journal of Pediatric Ophtha...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Kevin Lu Shen, MD Source Type: research

Preliminary Study of the Differences in Optic Nerve Head Hemoglobin Measures Between Patients With and Without Childhood Glaucoma
Classically, the pathogenesis of glaucomatous optic neuropathy has been described by two principal theories: mechanical and vascular. According to the mechanical theory, increased intraocular pressure causes stretching of the laminar beams and damage to the retinal ganglion cell axons. The vascular theory of glaucoma considers the neuropathy to be a consequence of insufficient blood supply due to either increased intraocular pressure or other risk factors that reduce ocular blood flow. Conditions including childhood, angle-closure, or secondary glaucomas clearly show that the presence of (Source: Journal of Pediatric Ophth...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Luc ía Perucho-González, MD, PhD Source Type: research

Retrospective Study of Visual Outcomes and Complications After Sutureless, Flapless, and Glueless Intrascleral Fixation of Posterior Chamber Intraocular Lens in Children and Young Adults
Inadequate capsular support for intraocular lens (IOL) implantation in the bag or ciliary sulcus is seen in congenital conditions of ectopia lentis (eg, Marfan syndrome, homocystinuria, Ehlers –Danlos syndrome, or Weill–Marchesani syndrome) and aphakia after complicated cataract surgery or traumatic subluxation.1 In the presence of little to no capsular support, the surgeon has the following options for lens implantation: an anterior chamber IOL, posterior chamber IOL over a residual capsule, iris-fixated IOL, iris-claw lens, scleral-fixated IOL, or scleral-fixated posterior chamber IOL. An (Source: Journal of Pediatri...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: V. Rajesh Prabu, DNB Source Type: research

FEVR-like Presentation in an 11q Deletion Syndrome and 16p13.11 Microdeletion
Familial exudative vitreoretinopathy (FEVR) is an inherited disorder characterized by poor development of the retinal vasculature, first described by Criswick and Schepens.1 Peripheral avascularity of the retina is a hallmark of the disease and can lead to neovascularization, vitreous hemorrhage, tractional retinal detachments, exudation, and amblyopia.2 Several genes involved in the Wnt signaling pathway in the retina are associated with the disease, but the most common are the FZD4, LRP5, TSPAN 12, and NDP genes, which are located on chromosomes 11q13 –q23, 7q31, and Xp11.3–5 Chromosome 11q (Source: Journal of Pediat...
Source: Journal of Pediatric Ophthalmology and Strabismus - November 21, 2017 Category: Opthalmology Authors: Maria D. Garcia, MD Source Type: research