Dermoid Cyst of Conjunctival Origin Attached to the Tarsus in a Pediatric Patient.

Dermoid cysts of cutaneous origin are common orbital lesions, whereas dermoid cysts of conjunctival origin are rare. The authors present a case of a dermoid cyst of conjunctival origin that was attached to the tarsus in a pediatric patient. A 2-year-old boy presented to the clinic with an approximately 2 cm in diameter mobile nodule in the upper eyelid on the temporal side that distorted the eyelid architecture with temporal ptosis.

Unilateral four muscle surgery for extra-large monocular exotropia.

Introduction: Recurrent exotropia is common following surgery for monocular large angle constant sensory exotropia. Surgery is usually limited to operations on the affected eye. Simultaneous oblique weakening surgery may enhance the effect of the horizontal rectus muscles surgery by decreasing the abducting forces.

Seven-year outcomes following intensive anti-vascular endothelial growth factor therapy in patients with exudative age-related macular degeneration.

Background: Anti-vascular endothelial growth factor (VEGF) therapy is currently the most effective therapy of exudative age-related macular degeneration (AMD). The aim of this study was to assess long-term benefits of intensive aflibercept and ranibizumab anti-VEGF therapy in patients with exudative AMD.

Methods: Two clinical trial sites recruited their original subjects for a re-evaluation 7 years after the baseline visit of the phase-3 Vascular Endothelial Growth Factor (VEGF) Trap-Eye: Investigation of Efficacy and Safety in Wet Age-Related Macular Degeneration (VIEW 2) trial.

Flipped classroom approach to global outreach: cross-cultural teaching of horizontal strabismus to Chinese ophthalmology residents.

Aim: To evaluate the flipped classroom model for teaching horizontal strabismus didactics in an ophthalmology residency program in China as part of a visiting professorship from the United States.

Methods: Residents from an ophthalmology residency program in China were invited to participate in flipped classroom sessions taught by an experienced American ophthalmology faculty in 2018. Residents were instructed to watch a pre-class video lecture prior to the in-class-case-based activity.

The flipped-classroom approach to teaching horizontal strabismus in ophthalmology residency: a multicentered randomized controlled study.

Background: The flipped-classroom involves watching prerecorded lectures at home followed by group learning exercises within the classroom. This study compares the flipped classroom approach with the traditional classroom for teaching horizontal strabismus didactics in ophthalmology residency.

Methods: In this multicenter, randomized controlled survey study from October 2017 to July 2018, 110 ophthalmology residents were taught esotropia and exotropia sequentially, randomized by order and classroom style.

Improvement in health-related quality of life following strabismus surgery for children with intermittent exotropia.

Purpose: To investigate health-related quality of life (HRQOL) after strabismus surgery in children with intermittent exotropia (IXT) and relationships between HRQOL and surgical success.

Methods: A total of 197 children with IXT aged 3-11 years (and 1 parent of each child) were enrolled in a previously reported randomized clinical trial comparing two surgical procedures. The Intermittent Exotropia Questionnaire (IXTQ) was administered before surgery (baseline), and again at 6 and 36 months following surgery.

Health-related quality of life in children with untreated intermittent exotropia and their parents.

Purpose: To determine whether health-related quality of life (HRQOL) scores improved or worsened over 3 years of observation in childhood intermittent exotropia without treatment.

Methods: A total of 111 children aged 3-11 years with intermittent exotropia were assigned to observation in a previously reported randomized trial comparing patching with observation. The intermittent exotropia questionnaire (IXTQ) was administered at baseline, 6 months, and 36 months.

The effect of nonmodifiable physician demographics on Press Ganey patient satisfaction scores in ophthalmology.

Press Ganey patient satisfaction scores are increasingly being used as a physician quality metric. In this retrospective review of over 25,000 patient surveys for 61 ophthalmologists, pediatric ophthalmologists and neuro-ophthalmologists received significantly lower patient satisfaction scores than their peers, suggesting that the problem for which a patient seeks care may affect whether he or she is satisfied with the care received. These findings should be taken into account when considering the validity of Press Ganey scores as an equitable, modifiable measure of physician performance, especially when considering factoring these scores into physician evaluation and reimbursement.

Assessment of Macular Microvasculature in Healthy Eyes of Infants and Children Using OCT Angiography.

Purpose: To assess macular vasculature in healthy infants and children using OCT angiography (OCTA).

Design: Prospective cross-sectional study.

Participants: One hundred thirty-five normal maculae of 89 healthy infants and children (mean age, 8.

Optical Coherence Tomography Normative Peripapillary Retinal Nerve Fiber Layer and Macular Data in Children 0-5 Years of Age.

Purpose: To determine reference values for the peripapillary retinal nerve fiber layer (pRNFL) and macula in children 0-5 years of age.

Design: Prospective cross-sectional study.

Methods: This study was set in a single large academic pediatric ophthalmology practice.

The flipped-classroom approach to teaching horizontal strabismus in ophthalmology residency: a pilot study.

Purpose: To compare the flipped classroom (home pre-taped lectures followed by in-class group exercise) to the traditional classroom (home reading assignment followed by in-class lecture) for horizontal strabismus didactics in ophthalmology residency.

Methods: All PGY2-4 residents from four U.S.

Postoperative infection following strabismus surgery: case series and increased incidence in a single referral center.

Purpose: To identify and analyze cases of postoperative infection following strabismus surgery at a large referral center and to report the incidence, risk factors, and outcomes.

Methods: An electronic database search identified strabismus procedures at Duke Eye Center from July 1996 to October 2017. Diagnosis codes for periocular infections were used to further identify patients with possible infections following strabismus surgery.

Sexual Harassment in Ophthalmology: A Survey Study.

This anonymous survey identifies a sexual harassment prevalence of 59% among ophthalmologists responding through the Women in Ophthalmology listserv. The authors urge implementation of sexual harassment policies within our professional societies, accreditation councils and workplaces.

Microphthalmia, Dermal Aplasia, and Sclerocornea Syndrome: Endoscopic Cyclophotocoagulation in the Management of Congenital Glaucoma.

Purpose: To report on the use of endoscopic cyclophotocoagulation (ECP) to treat congenital glaucoma in a triple X female with microphthalmia, dermal aplasia, and sclerocornea (MIDAS) syndrome.

Observations: The patient demonstrated linear streaks on the face and neck consistent with dermal aplasia. The corneas were scleralized with ectatic areas of corneal thinning, and the eyes were microphthalmic.

Multifocal iris melanoma in a 2-year-old managed with I-125 plaque brachytherapy.

We report a 23-month-old patient presenting with multifocal iris melanoma who underwent plaque brachytherapy with full corneal coverage. The lesion demonstrated several high-risk clinical and histopathologic features associated with iris melanoma in adults, including growth and angle seeding. The patient has been subsequently followed for 3.

A double-masked randomized trial of postoperative local anesthetic for pain control in pediatric strabismus surgery.

Purpose: To determine to what extent local anesthetic reduces postoperative pain after pediatric strabismus surgery.

Methods: In this double-masked, randomized clinical trial of 50 children 13-91 months of age undergoing strabismus surgery, subjects were randomly assigned to one of three treatments given at the conclusion of surgery: topical lidocaine gel and sub-Tenon's (balanced salt solution) placebo (n = 16), topical placebo (hypromellose) and sub-Tenon's bupivacaine 0.75% (n = 17), or topical and sub-Tenon's placebo (n = 17).

A novel method for teaching key steps of strabismus surgery in the wet lab.

The surgical laboratory environment plays an important role in modern surgical education. Learning how to complete the key steps of strabismus surgery prior to actual surgery may enhance efficiency and sensitize the surgeon to potential complications. Cadaveric extraocular muscle is difficult to manipulate and specimens are not readily available; therefore, an alternative is needed to teach strabismus surgery techniques.

Congenital microcephaly and chorioretinopathy due to de novo heterozygous KIF11 mutations: five novel mutations and review of the literature.

The microcephaly-lymphedema-chorioretinal dysplasia (MLCRD) syndrome is a distinct microcephaly syndrome. The hallmark features, microcephaly, chorioretinopathy, and lymphedema are frequently recognized at birth. Another clinical entity, the chorioretinal dysplasia, microcephaly and mental retardation syndrome (CDMMR) is a highly overlapping syndrome characterized by more variable lymphedema.

The accuracy of photoscreening at detecting treatable ocular conditions in children with Down syndrome.

Background: Children with Down syndrome (DS) have an increased prevalence of ocular disorders, including amblyopia, strabismus, and refractive error. Health maintenance guidelines from the Down Syndrome Medical Interest Group recommend ophthalmologic examinations every 1 to 2 years for these children. Photoscreening may be a cost-effective option for subsequent screening evaluations after an initial complete examination, but no study has evaluated the accuracy of photoscreening in children with DS.

Latanoprost in pediatric glaucoma--pediatric exposure over a decade.

Background: Although numerous studies of latanoprost in adult glaucoma have shown it to be an effective hypotensive agent with a low incidence of side effects, these issues have not been well studied in pediatric glaucomas. The purpose of the current study is to evaluate the safety and intraocular pressure (IOP) lowering effect of latanoprost in various pediatric glaucomas over a long period.

Subjects And Methods: This retrospective study included all children treated with latanoprost at our institution from 1996 to 2007.

Travoprost in children: adverse effects and intraocular pressure response.

Because of the limited ability to perform controlled, randomized studies in children, the safety and effectiveness of topical medications in pediatric glaucoma is sometimes difficult to determine. Although travoprost has been commercially available since 2001, there are no published reports on its use in children. This retrospective study found travoprost to have minimal adverse events in children and to reduce IOP in select cases of pediatric glaucoma.