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.

Eight-Year Outcomes of Bilateral Lateral Rectus Recessions versus Unilateral Recession-Resection in Childhood Basic-Type Intermittent Exotropia.

Purpose: To report 8-year outcomes from a randomized controlled trial (RCT) comparing bilateral lateral rectus muscle recession (BLRc) with unilateral recession-resection (R&R) for childhood intermittent exotropia (IXT).

Design: Eight-year follow-up of RCT cohort.

Participants: Of 197 randomized participants, 123 agreed to continue follow-up after the 3-year outcome visit (baseline age, 3-< 11 years; basic-type IXT, 15-40 prism diopters [Δ] by prism and alternate cover test [PACT]; baseline stereoacuity, ≤ 400 arcsec; no prior surgery).

Medical Student Perception of Strabismus in Race Implicit Association Test.

Purpose: To determine whether the appearance of strabismus is noted in a race implicit association test by medical students.

Methods: Medical students participated in a survey evaluating for the appearance of strabismus in photographs from a commonly used race implicit association test. Analysis was performed to determine whether strabismus was perceived equally between both groups tested.

Increasing incidence and risk factors for divergence insufficiency esotropia.

Purpose: To document the increasing incidence of divergence insufficiency (DI) esotropia and to identify risk factors for DI.

Methods: All patients with a diagnosis of esotropia seen by one provider (DLG) over 41 years were identified from the medical record. Patients with onset of strabismus before age 10 years or with prior strabismus surgery were excluded.

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.

Overminus Lens Therapy for Children 3 to 10 Years of Age With Intermittent Exotropia: A Randomized Clinical Trial.

Importance: This is the first large-scale randomized clinical trial evaluating the effectiveness and safety of overminus spectacle therapy for treatment of intermittent exotropia (IXT).

Objective: To evaluate the effectiveness of overminus spectacles to improve distance IXT control.

Design, Setting, And Participants: This randomized clinical trial conducted at 56 clinical sites between January 2017 and January 2019 associated with the Pediatric Eye Disease Investigator Group enrolled 386 children aged 3 to 10 years with IXT, a mean distance control score of 2 or worse, and a refractive error between 1.

Diagnosis of Accommodative Spasm Aided by Handheld Photoscreener.

We report a case of accommodative spasm in an 8-year-old girl discovered by handheld photoscreener. The patient was found to have a Chiari I malformation, and managed with atropine drops and reading glasses, ultimately with improvement in her symptoms. We believe this to be the first case of accommodative spasm diagnosis aided by the use of a handheld photoscreener.

A Randomized Trial of Binocular Dig Rush Game Treatment for Amblyopia in Children Aged 7 to 12 Years.

Purpose: To compare visual acuity (VA) improvement in children aged 7 to 12 years with amblyopia treated with a binocular iPad game plus continued spectacle correction vs. continued spectacle correction alone.

Design: Multicenter randomized clinical trial.

Pathological Examination of Plicated Medial Rectus Muscle for Treatment of Re-recurrent Exotropia.

Plication and resection are surgical procedures commonly used for the treatment of strabismus. Further studies are needed to understand the postoperative effects of plication on muscle tissue. This case report examines a pathological section of a plicated medial rectus muscle, revealing myocyte injury and replacement with fibroconnective tissue.

Topical timolol for an iris hemangioma.

Extraocular infantile hemangiomas have been shown to respond to oral and topical beta blockers, while there is little literature regarding the management of intraocular infantile hemangiomas with beta blockers. This case report discusses the management of an iris hemangioma with topical timolol, a treatment previously unreported in the literature.

Nonabsorbable versus absorbable sutures in large, hang-back medial rectus muscle recessions.

Purpose: To investigate the value of nonabsorbable sutures in reducing the incidence of consecutive exotropia after large, "hang-back" medial rectus recessions.

Methods: The medical records of patients who underwent medial rectus recession of ≥6.5 mm in individuals ≤2 years of age, or ≥7.

Deficiency of depression in adduction: clinical characteristics and surgical management of the "inverted Brown pattern".

Purpose: To evaluate the clinical characteristics and surgical management of patients with an "inverted Brown pattern," which is defined clinically as a hypertropia with greatest deviation in down-and-in gaze of the higher eye, having the appearance of superior oblique muscle underaction but without significant inferior oblique muscle overaction.

Methods: The medical records of patients with this misalignment pattern who had cyclovertical muscle surgery at our institution from 2003 through 2015 were retrospectively reviewed; medical records were analyzed for pre- and postoperative motility patterns, fundus torsion, intraoperative findings, and type of strabismus surgery.

Results: A total of 45 patients presenting with a hyperdeviation worse in down-and-in gaze of the higher eye were included in the study.

Accuracy of double Maddox rod with induced hypertropia in normal subjects.

Background And Purpose: The double Maddox rod is a commonly used instrument to test for cyclotorsion in the clinical setting. This paper assesses the ability of patients without torsional complaint to accurately demonstrate torsional status with varying degrees of induced hypertropia as tested by double Maddox rod.

Methods: Thirty-seven orthophoric subjects underwent double Maddox rod testing with vertical prism of 3(Δ), 10(Δ), 16(Δ), 20(Δ), and 30(Δ).