Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus

Aplasia of the inferior rectus and inferior oblique muscles is extremely rare. Failure of the normal embryologic development of the inferior mesodermal complex can lead to agenesis of inferior rectus, inferior oblique, and lower sections of the lateral rectus muscles. This rare condition usually seen in association with craniofacial syndromes or in conjunction with microcornea, microphthalmos, Axenfeld-Rieger syndrome, and coloboma. The usual treatment for this condition is a reverse Knapp procedure to improve the vertical alignment; however, this procedure can lead to complications, such as anterior segment ischemia, undercorrection, and torsional problems...

PURPOSE: To compare amblyopia treatment outcomes between patients with neurodevelopmental disorders and their typically developing peers. METHODS: Of 2,311 patients diagnosed with amblyopia between 2010 and 2014 at Boston Children's Hospital, 460 met inclusion criteria (age 2-12 with anisometropic, strabismic, or mixed amblyopia [interocular difference (IOD) ≥2 lines]). Treatment and visual outcomes were analyzed according to neurodevelopmental status: neurodevelopmental delay (DD) versus typical development (TD)...

PURPOSE: To determine the incidence of tympanostomy tube (T-tube) insertion in children who required probing and intubation for congenital nasolacrimal duct obstruction (CNLDO) at a single academic institution and to analyze success rates. METHODS: The medical records of 92 patients who underwent nasolacrimal probing and intubation for CNLDO over a 9-year period were reviewed retrospectively. A preoperative questionnaire was given to the patient's guardian concerning laterality of CNLDO, history of otitis media (OM) antibiotic therapy, history of T-tube placement and number placed...

PURPOSE: To determine the relationship between intermittent exotropia (IXT) and refractive change and the effects of the methods applied in IXT follow-up on refractive change. METHOD: The medical records of 228 patients with IXT (group 1) and 110 patients without strabismus (group 2) who were followed between 2008 and 2022 were analyzed retrospectively. Group 1 was divided into three subgroups: overminus correction (group 1A), patients who underwent surgery (group 1B), and patients who were observed (group 1C)...

Poor control of intermittent exotropia may be used as an indication for surgery. However, control fluctuates during the day and from day to day. The standardized triple office control score (mean of three scores on a 6-point ordinal scale) is representative of repeated assessments throughout the day, but lacks validation against an objective measure of eye movements. We report the agreement between the triple office control score measured by the referring eyecare professional and lab-measured vergence instability using an EyeLink video eye tracker...

PURPOSE: To evaluate the rates of visually significant disorders in patients without treatment-requiring retinopathy of prematurity (ROP) at initial follow-up after completion of ROP examinations. METHODS: The medical records of all babies evaluated for retinopathy of prematurity between June 2015 and September 2020 were reviewed. Patients with documented gestational age, birth weight, and single versus multiple birth status who did not require ROP treatment and who followed-up with our institution's pediatric ophthalmologist were included...

PURPOSE: Neonatal retinal hemorrhage is a common finding in newborns, but the underlying mechanisms are not fully understood. A computational simulation was designed to study the events taking place in the eye and orbit when the head is compressed as the neonate passes through the birth canal. METHODS: A finite element model of the eye, optic nerve sheath, and orbit was simulated and subjected to forces mimicking rises in intracranial pressure (ICP) associated with maternal contractions during normal vaginal delivery...

BACKGROUND: Amblyopia is a common cause of monocular vision impairment and disproportionally affects developmentally delayed children. Photoscreeners have been suggested as a method to detect amblyopia risk factors (ARFs) in children with developmental disabilities who may not be amenable to traditional vision screening methods. The Spot Vision Screener is a commonly used photoscreener for detecting ARF and has shown excellent sensitivity and accuracy in the general pediatric population...

BACKGROUND: Children with unexplained bilateral cataracts routinely undergo testing for genetic, infectious, and metabolic etiologies. We evaluated the diagnostic yield of various tests ordered by pediatric ophthalmologists to evaluate bilateral cataracts in children at a single institution. METHODS: We retrospectively identified all children with bilateral unexplained cataracts who underwent cataract surgery by a pediatric ophthalmologist at Children's Hospital Colorado from 2006 to 2022...

PURPOSE: To investigate whether abnormal head posture (AHP) induces changes in common carotid artery blood flow (CCBF), thereby leading to the development of facial asymmetry in the setting of strabismus and ocular torticollis. METHODS: This was a prospective observational study of pediatric subjects in an urban ophthalmology clinic who underwent bilateral carotid artery ultrasound examination with spectral Doppler in an upright, straight-head posture and with a head tilt of 30°-45° to the right and left...

We report the case of a 15-year-old boy with hypertensive retinopathy and Purtscher-like retinopathy eventually diagnosed with complement 3 glomerulopathy (C3G). The patient presented with bilateral severe painless visual loss and posterior pole cotton wool spots, optic disk and macular edema, and macular star-shaped hard exudate depositions, arterial narrowing, and venous tortuosity, indicative of hypertensive retinopathy (with an initial blood pressure of 210/130 mm Hg) and Purtscher-like retinopathy. He was subsequently diagnosed with C3G based on results of a kidney biopsy...

PURPOSE: To evaluate the ability of observers to accurately detect strabismus using an alternate cover testing approach via telemedicine and to assess the effect of various factors related to video conditions on the accuracy rate. METHODS: Videos were made by the authors in which different angles of strabismus, up to 12Δ , were induced by prism and recorded using alternate cover testing. The videos were made under a variety of conditions that incorporated various head postures, lighting, fixation target position and motion, and viewing angle...

PURPOSE: To review the published literature assessing the clinical utility of genetic testing in individuals with infantile nystagmus syndrome (INS), defined as binocular conjugate nystagmus and onset prior to 6 months of age, with or without associated findings. METHODS: A literature search was last conducted in October 2022. The results were limited to articles published in English. The search yielded 517 abstracts, of which 72 papers were reviewed in full text...

Unilateral congenital cataracts lead to deprivation amblyopia, which can be severe. Until the 1970s, they were believed to be always associated with poor visual outcomes. However, advances in our understanding of the plasticity of the infant brain and the development of better surgical techniques allowed good visual outcomes to be obtained in a few of these patients. The Infant Aphakia Treatment Study (IATS) was conducted to provide empirical evidence regarding the best type of optical correction to be used following surgical extraction of the cataract...

No abstract text is available yet for this article.

It is generally believed that the visual acuity of an amblyopic eye cannot improve significantly in adulthood. However, there have been reports of this occurring following visual loss in the fellow eye. Best-corrected visual acuity improvement in amblyopic eyes of children with strabismic amblyopia following strabismus surgery has also been reported. We present the case of an adult whose visual acuity in his amblyopic eye improved 4 Snellen lines over 28 months following strabismus surgery.

PURPOSE: To investigate the population-based incidence and de novo mutation rate of Marfan syndrome and risk of ectopia lentis. METHODS: Patients newly diagnosed with Marfan syndrome in Olmsted County, Minnesota, from January 1, 1976, through December 31, 2005, were identified through medical records review. Outcome measures were Marfan incidence, de novo mutation rate, risk of ectopia lentis. RESULTS: Marfan syndrome was identified in 17 patients during the 30-year period, yielding an incidence of 0...

PURPOSE: To analyze the surgical results of patients treated for superior oblique palsy with coexisting exotropia. METHODS: The medical records of patients with superior oblique palsy and exotropia who underwent inferior oblique weakening and simultaneous lateral rectus recession by a single surgeon from 1996 to 2022 were reviewed retrospectively. Demographics, pre- and postoperative vertical and horizontal deviation, and presence of diplopia were recorded. Surgical success was defined as horizontal deviation <10Δ and vertical deviation ≤4Δ without overcorrection or diplopia...

No abstract text is available yet for this article.

No abstract text is available yet for this article.