Cup-to-disc ratio measured clinically and via OCT in pediatric patients being monitored as glaucoma suspects for suspicious optic discs.

Purpose: Compare cup-to-disc ratio (CDR) measured by clinical assessment and optical coherence tomography (OCT) in pediatric eyes being monitored as glaucoma suspects for suspicious optic disc appearance.

Design: Retrospective cross-sectional study.

Methods: An institutional study following 221 eyes from 122 unique pediatric glaucoma suspects being monitored due to increased or asymmetric appearance of CDR.

Ocular manifestations of SREBF1-associated hereditary mucoepithelial dysplasia.

Hereditary mucoepithelial dysplasia (HMD) is a rare autosomal dominant dysplastic dyskeratotic epithelial syndrome caused by pathogenic variants in the SREBF1 gene. This syndrome is associated with a variety of ocular conditions, including cataracts, nystagmus, keratitis, meibomian gland dysfunction (MGD), and decreased visual acuity. We report the case of a boy followed from 1 to 7 years of age who had a confirmed HMD-associated variant in the SREBF1 gene.

Social media and amblyopia: evaluating content and intent on Instagram.

: Social media is a widely-used avenue for the public to find health information. In particular, Instagram is a popular social media platform among adults who may have children within the amblyogenic age range, and it may be used to find amblyopia-related information. The purpose of this study is to assess the quality of the amblyopia information on Instagram.

Pupillary Light Reflex Detected by Ophthalmic Ultrasonography in Critically Ill Children With Difficult to Assess Pupils.

Direct visualization of the eye can be difficult or impossible when there is significant facial burns, trauma, or edema. We present 4 nonresponsive, critically ill children whose pupils could not be directly visualized. Ophthalmic ultrasound revealed pupillary reactivity at presentation and throughout their recovery.

Doses of medial rectus muscle recessions for divergence insufficiency-type esotropia.

We evaluated whether doses of bilateral medial rectus recessions greater than Parks's tables yielded superior outcomes for adult-onset divergence insufficiency. Forty-two patients underwent bilateral medial rectus recessions. Dose was analyzed as the average total per muscle (surgery + suture adjustment if performed) and compared with the standard dose tables (based on preoperative distance esodeviation), as difference between dose performed and dose indicated by Parks's tables.

Impact of social determinants of health on follow-up adherence, testing completion, and outcomes among pediatric glaucoma patients at a tertiary care center.

Purpose: To identify patient characteristics associated with visit attendance, treatment outcomes, and optical coherence tomography (OCT) testing in pediatric glaucoma patients at an urban tertiary care center.

Methods: The records of patients with childhood glaucoma seen from 2015 to 2021 were reviewed. Primary outcomes were the proportion of scheduled visits completed, visual acuity and intraocular pressure (IOP) at most recent follow-up, and rates of OCT testing.

Ophthalmologic Findings in Children with Neurofibromatosis Type 1.

The purpose of this study was to evaluate the ophthalmologic findings in children with neurofibromatosis type 1 (NF1) and compare these findings in eyes with and without optic pathway gliomas (OPGs). We carried out a retrospective chart review of children with NF1. We recorded demographic characteristics, clinical manifestations of disease, and ophthalmologic findings including visual acuity, intraocular pressure, cup-to-disc ratio, visual field testing, and optical coherence tomography findings.

Micropulse cyclophotocoagulation compared to continuous wave cyclophotocoagulation for the management of refractory pediatric glaucoma.

Introduction: Micropulse cyclophotocoagulation (MPCPC) has been shown in adults to offer a favorable post-operative safety profile compared to continuous wave transscleral cyclophotocoagulation (CWCPC) in the management of glaucoma. The purpose of this study is to evaluate the long term efficacy, safety, and effectiveness of MPCPC in the management of pediatric glaucoma when compared to CWCPC.

Methods: IRB approved retrospective chart review of patients with pediatric glaucoma that underwent MPCPC and CWCPC at 2 separate institutions.

Netarsudil in the management of refractory pediatric glaucoma.

We performed a retrospective review of patients with refractory pediatric glaucoma who were started on netarsudil at the Wilmer Eye Institute. We found minimally sustained IOP lowering over a 6-month period in 29 eyes of 23 patients. Our results suggest that although netarsudil is an alternative medication in the management of pediatric glaucoma, its efficacy may be limited in refractory pediatric glaucoma patients.

Clear lens extraction and refractive lens exchange for the treatment of amblyopia.

Treatment of amblyopia typically involves spectacles or penalization of the nonamblyopic eye with occlusive patching or pharmacological penalization. However, these methods can be ineffective or difficult in certain children who may be unable to tolerate or are poorly compliant with such therapies. Untreated high refractive error can result in dense amblyopia, and thus, other treatment methods are necessary in this subset of children.

A Pilot Randomized Clinical Trial of Base-in Relieving Prism Spectacle Treatment of Intermittent Exotropia.

Significance: This pilot randomized trial, the first to evaluate a specific base-in relieving prism treatment strategy for childhood intermittent exotropia, did not support proceeding to a full-scale clinical trial. Defining and measuring prism adaptation in children with intermittent exotropia are challenging and need further study.

Purpose: This study aimed to determine whether to proceed to a full-scale trial of relieving base-in prism spectacles versus refractive correction alone for children with intermittent exotropia.

Conversion to Glaucoma in Pediatric Glaucoma Suspects.

Prcis: In this retrospective review of pediatric glaucoma suspects, 11.5% of eyes progressed to glaucoma over an average of 6.5 years; eyes with ocular hypertension had an 18-fold increased risk of progression compared with eyes with suspicious disc appearance.

Maternity and family leave experiences among female ophthalmologists in the United States.

Objective: To evaluate family and maternity leave policies and examine the social and professional impacts on female ophthalmologists.

Participants: Participants were recruited through the Women in Ophthalmology online list-serv to complete a survey evaluating maternity leave policies and their impacts. Survey questions were repeated for each birth event after medical school for up to five birth events.

The Ophthalmic Manifestations of Down Syndrome.

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400-1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal duct obstruction, nystagmus, keratoconus, cataracts, retinal abnormalities, optic nerve abnormalities, and glaucoma.

Baltimore pediatric ocular trauma study: Health disparities and outcomes in pediatric and adolescent open globe trauma.

Purpose Children represent approximately one-third of patients with serious ocular injuries. Our study evaluates associations between race and socioeconomic status in presentation and outcomes of pediatric and adolescent traumatic open globe injuries. Methods We conducted a retrospective chart review of traumatic open globe injuries in pediatric and adolescent patients presenting to Johns Hopkins Hospital and University of Maryland Medical Center between 2006 and 2020.

Visual Acuity and Ophthalmic Outcomes 5 Years After Cataract Surgery Among Children Younger Than 13 Years.

Importance: Cataract is an important cause of visual impairment in children. Data from a large pediatric cataract surgery registry can provide real-world estimates of visual outcomes and the 5-year cumulative incidence of adverse events.

Objective: To assess visual acuity (VA), incidence of complications and additional eye operations, and refractive error outcomes 5 years after pediatric lensectomy among children younger than 13 years.

Telemedicine utilization by pediatric ophthalmologists during the COVID-19 pandemic.

Understanding provider perspectives on telemedicine adoption during the COVID-19 pandemic can help inform best practices for delivering pediatric ophthalmic care safely and remotely. In this online survey distributed to two national pediatric ophthalmology list-servs, respondents in July-August 2020 (n = 104) compared with respondents in March-April 2020 (n = 171) were more likely to report not using and not planning on using telemedicine. The July-August respondents who did not use telemedicine were concerned about the limitations in care provided, challenges with implementation, and perceived negative effects on the doctor-patient relationship.

A prospective study of treatments for adult-onset divergence insufficiency-type esotropia.

Purpose: To describe 10-week and 12-month outcomes following treatment for divergence insufficiency-type esotropia in adults.

Methods: In this prospective observational study, 110 adults with divergence insufficiency-type esotropia, with a distance esodeviation measuring 2 to 30 and at least 25% larger at distance than near, and binocular diplopia present at least "sometimes" at distance, were enrolled at 28 sites when initiating new treatment. Surgery, prism, or divergence exercises/therapy were chosen at the investigator's discretion.

Factors leading to loss to follow-up after strabismus surgery in children.

Purpose: To assess risk factors for loss to follow-up (LTFU) and identify obstacles to follow-up care in these patients.

Methods: The medical records of all children (<18 years old) who underwent strabismus surgery over a 6-year period at a single institution were reviewed retrospectively. Patients were considered LTFU if they failed to attend a follow-up appointment between 3 weeks and 6 months postoperatively.

Using IOLs for anterior segment photography in children.

We present a novel and convenient technique for obtaining clear, high-resolution anterior segment images using an expired intraocular lens (IOL) over the lens of a smartphone's camera. Our technique provides the means to acquire high-quality images when expensive anterior segment imaging devices are unavailable. A further advantage is decreasing the economic and environmental costs of expired IOLs, whose life can be extended through "recycling" as adjunctive camera lenses.

Practice Patterns in the Surgical Management of Pediatric Traumatic Cataracts.

Purpose: To facilitate the development of standardized guidelines for the surgical management of patients with pediatric traumatic cataracts by assessing current ophthalmologists' practice patterns.

Methods: This was a cross-sectional, observational, and retrospective study. A 24-question electronic survey of current practices pertaining to the surgical management of pediatric traumatic cataracts was sent to pediatric ophthalmologists worldwide.

A comparison of ocular trauma scores in a pediatric population.

Objective: Pediatric ocular trauma represents a major concern for ophthalmologists. Delays in presentation, incomplete exams, inaccurate visual acuity (VA) results, and amblyopia can limit accurately predicting final visual outcomes in pediatric eye trauma. We performed a retrospective clinical study to describe the demographics and causes of eye trauma.

Presence of Posterior Staphyloma in Congenital Cataract Children.

: To investigate the prevalence of posterior staphyloma (PS) in congenital cataract children and its role in predicting postoperative axial elongation.: Preoperative prevalence of PS in 520 congenital cataract patients was reviewed and compared with that of the healthy eyes of 300 unilateral traumatic cataract children after 1:1 propensity score matching. Then, 32 pseudophakic children with preoperative PS and 48 age-matched pseudophakic controls without preoperative PS were followed up after the surgery, to compare their axial growth rates and refractive changes.