Slow Binocular Reading in Amblyopic Children Is a Fellow Eye Deficit.

Significance: Amblyopic children read 25% slower than their peers during binocular silent reading.

Purpose: We compared binocular reading to fellow eye reading to determine whether slow reading in amblyopic children is due to binocular inhibition; that is, the amblyopic eye is interfering during binocular reading.

Methods: In a cross-sectional study, 38 children with amblyopia and 36 age-similar control children who completed grades 1 to 6 were enrolled.

Temporal Eye-Hand Coordination During Visually Guided Reaching in 7- to 12-Year-Old Children With Strabismus.

Purpose: We recently found slow visually guided reaching in strabismic children, especially in the final approach. Here, we expand on those data by reporting saccade kinematics and temporal eye-hand coordination during visually guided reaching in children treated for strabismus compared with controls.

Methods: Thirty children diagnosed with esotropia, a form of strabismus, 7 to 12 years of age and 32 age-similar control children were enrolled.

Randomized clinical trial of streaming dichoptic movies versus patching for treatment of amblyopia in children aged 3 to 7 years.

Contrast-rebalanced dichoptic movies have been shown to be an effective binocular treatment for amblyopia in the laboratory. Yet, at-home therapy is a more practical approach. In a randomized clinical trial, we compared dichoptic movies, streamed at-home on a handheld 3D-enabled game console, versus patching as amblyopia treatment.

A randomized clinical trial of contrast increment protocols for binocular amblyopia treatment.

Background: Most clinical trials of contrast-rebalanced binocular amblyopia treatment used a contrast increment protocol of 10% daily with successful play. Paired with a definition of success requiring only 15-30 min/day of gameplay, this increment protocol could allow children to reach 100% fellow eye contrast in 3-9 hours; however, this may not provide adequate therapeutic time with reduced fellow eye contrast. The purpose of this study was to compare the original protocol against three alternative contrast increment protocols designed to increase the number of treatment hours.

Binocular reading in children following extraction of a dense congenital or infantile unilateral cataract.

Background: Reading relies on ocular motor function, requiring sequential eye movements (forward and regressive saccades). Binocularly discordant input from a dense congenital or infantile cataract is associated with ocular motor dysfunction and may affect the development of reading ability. The purpose of this study was to assess silent, binocular reading in children treated for unilateral congenital or infantile cataract.

Impaired fine motor skills in children following extraction of a dense congenital or infantile unilateral cataract.

Purpose: To evaluate fine motor ability in children treated for unilateral congenital or infantile cataract.

Methods: Twenty-three children 3-13 years of age who were treated for unilateral congenital or infantile cataract and 38 age-similar control children were enrolled. Children completed five fine motor skills tasks (unimanual dexterity, bimanual dexterity, drawing trail, aiming, catching) from the Movement Assessment Battery for Children-2.

Binocular iPad treatment for amblyopia in preschool children.

Background: Recent experimental evidence supports a role for binocular visual experience in the treatment of amblyopia. The purpose of this study was to determine whether repeated binocular visual experience with dichoptic iPad games could effectively treat amblyopia in preschool children.

Methods: A total of 50 consecutive amblyopic preschool children 3-6.

Postoperative glaucoma following infantile cataract surgery: an individual patient data meta-analysis.

Importance: Infantile cataract surgery bears a significant risk for postoperative glaucoma, and no consensus exists on factors that may reduce this risk.

Objective: To assess the effect of primary intraocular lens implantation and timing of surgery on the incidence of postoperative glaucoma.

Data Sources: We searched multiple databases to July 14, 2013, to identify studies with eligible patients, including PubMed, MEDLINE, EMBASE, ISI Web of Science, Scopus, Central, Google Scholar, Intute, and Tripdata.

Beyond screening for risk factors: objective detection of strabismus and amblyopia.

Importance: Commercially available automated vision screening devices assess refractive risk factors, not amblyopia or strabismus, underreferring affected children and overreferring healthy children. Nearly half of affected children are not identified until after age 5 years, when treatment is less effective.

Objectives: To determine the diagnostic accuracy of the Pediatric Vision Scanner (PVS), a binocular retinal birefringence scanner, to objectively identify strabismus and amblyopia, and to compare retinal birefringence screening with a widely used automated pediatric screening device.

Visual acuity deficits in children with nystagmus and Down syndrome.

Purpose: To investigate the association between visual acuity deficits and fixation instability in children with Down syndrome and nystagmus.

Design: Prospective cross-sectional study.

Methods: setting: Institutional.

Unilateral lateral rectus resection for horizontal diplopia in adults with divergence insufficiency.

Background: Divergence insufficiency (DI) is an acquired comitant strabismus in aging individuals, characterized by esotropia and diplopia at distance. Treatment options include occlusion, base-out prism glasses, and a variety of surgical procedures to the horizontal rectus extraocular muscles. Here, we present a large cohort of patients with DI who underwent unilateral resection of the lateral rectus muscle.

New strabismus surgical techniques.

Five new strabismus surgical procedures were developed by the authors and were presented as a workshop at the AAPOS annual meeting of the American Association for Pediatric Ophthalmology and Strabismus. They are summarized here to introduce these methods to the reader and provide surgeons with more options in approaching difficult strabismus problems. Diagnosis and correction of consecutive strabismus attributable to stretched scar is discussed.

Fixation control and eye alignment in children treated for dense congenital or developmental cataracts.

Background: Many children treated for cataracts develop strabismus and nystagmus; however, little is known about the critical period for adverse ocular motor outcomes with respect to age of onset and duration.

Methods: Children who had undergone extraction of dense cataracts by the age of 5 years were enrolled postoperatively. Ocular alignment was assessed regularly throughout follow-up.

Vernier acuity cards: examination of development and screening validity.

Purpose: Because vernier acuity seems to be limited by the visual cortex, it possesses excellent potential as a clinical/screening tool to detect amblyopia in infants and toddlers. Thus, we developed the vernier acuity cards specifically for this age group. We compared developmental data gathered using this new test and the Teller Acuity Cards.

Oral reading after treatment of dense congenital unilateral cataract.

Background: Good long-term visual acuity outcomes for children with dense congenital unilateral cataracts have been reported after early surgery and good compliance with postoperative amblyopia therapy. However, treated eyes rarely achieve normal visual acuity, and there has been no formal evaluation of the utility of the treated eye for reading.

Methods: Eighteen children previously treated for dense congenital unilateral cataract were tested monocularly with the Gray Oral Reading Test, 4th edition (GORT-4) at 7 to 13 years of age with the use of 2 passages for each eye, one at grade level and one at +1 above grade level.

Onset and progression of with-the-rule astigmatism in children with infantile nystagmus syndrome.

Purpose: The purpose of this study was to examine the onset and progression of with-the-rule (WTR) astigmatism during the first 8 years of life in children with idiopathic infantile nystagmus syndrome (INS) or INS associated with albinism and to compare their development with that of normal children. Also explored was whether early WTR astigmatism influences emmetropization in children with INS and whether there is evidence of meridional emmetropization.

Methods: Cycloplegic refractions culled from medical records were converted into power vector components: M (spherical equivalent), J(0) (positive J(0) indicates WTR astigmatism), and J(45) (oblique astigmatism).

Photographic assessment of changes in torsional strabismus.

The horizontal and vertical components of strabismus are measured routinely and relatively easily in the clinical setting using prism-and-cover and/or corneal light reflex tests. The third dimension of ocular alignment, ocular torsion, is more difficult to assess. Objective torsional deviation (cyclotropia) is evaluated qualitatively with fundus examination.

The teller acuity cards are effective in detecting amblyopia.

Purpose: Detection of amblyopia in infants and toddlers is difficult because the current clinical standard for this age group, fixation preference, is inaccurate. Although grating acuity represents an alternative, studies of preschoolers and schoolchildren report that it is not equivalent to the gold standard optotype acuity. Here, we examine whether the Teller Acuity Cards (TAC) can detect amblyopia effectively by testing children old enough (7.

The critical period for surgical treatment of dense congenital bilateral cataracts.

Introduction: We examined the critical period for deprivation amblyopia in a cohort of patients with dense bilateral congenital cataracts to investigate the optimum timing for surgical treatment.

Methods: Thirty-seven infants with dense bilateral congenital cataracts that were extracted by 31 weeks of age were enrolled prospectively. Visual acuity outcome was assessed at >/=5 years of age.

Improvement in motor development following surgery for infantile esotropia.

Purpose: Infantile esotropia is associated with abnormal visual development and thus may delay the achievement of developmental milestones. Although early surgery can improve visual function, less is known about its effect on motor development. Here we address whether early surgery can improve motor development.

Surgical findings with the tinted AcrySof intraocular lens in children.

Introduction: The AcrySof foldable acrylic intraocular lens (IOL) has become an accepted and frequent means of treating pediatric aphakia. A new version of this lens with blue-light filtering properties purports to offer superior retinal protection. We describe our experience with this tinted lens and compare it to findings with the standard, nontinted IOL.

Anterior and nasal transposition of the inferior oblique muscles in patients with missing superior oblique tendons.

Introduction: Patients with missing superior oblique (SO) tendons present with overelevation/underdepression in adduction. Unilateral cases often exhibit abnormal head postures, whereas in bilateral cases, there may be a marked V-pattern with upgaze exotropia. These patients may have craniosynostosis.