Is the presence of peripapillary hyperreflective ovoid mass-like structures (PHOMS) in children related to the optic disc area, scleral canal diameter and refractive status?

Purpose: Peripapillary hyperreflective ovoid mass-like structures (PHOMS) have been recently described on optical coherence tomography (OCT) scans of the optic nerve. We aim to determine if there is a causal relationship between OCT measurements of the optic disc area (DA), scleral canal diameter (SCD) and refractive error (spherical equivalent, SE) on the presence of PHOMS.

Methods: Retrospective analysis of OCT scans which were graded for the presence or absence of PHOMS in children with suspected papilledema was undertaken.

The incidence, clinical features, and management of essential infantile esotropia in the United Kingdom. A British Ophthalmology Surveillance Unit (BOSU) study.

Background/objectives: A national study was undertaken through the British ophthalmology surveillance unit (BOSU) to determine the incidence, presenting features and management of essential infantile esotropia (EIE) in the UK.

Methods: Data from a prospective national observational study of newly diagnosed EIE presenting to clinicians in the United Kingdom over a 12-month period were collected. Cases with a confirmed diagnosis by a clinician of a constant, non-accommodative esotropia ≥20 prism dioptres (PD), presenting at ≤12 months, with no neurological or ocular abnormalities were identified through BOSU.

The use of occlusive contact lenses after failure of conventional for treatment of amblyopia.

Purpose: The purpose of this study was to evaluate the usefulness and assess the risks associated with occlusive contact lenses (OCLs) use to treat refractory amblyopia in children who failed the conventional amblyopia treatment with patching and atropine penalization.

Methods: This was a retrospective case series of all children treated with an OCL in the sound eye over an 8-year period. Data were collected on the age, gender, and type of amblyopia, previous treatment received, and its duration.

Stress and cataract surgery: A nationwide study evaluating surgeon burnout.

Background: We aimed to evaluate the nationwide prevalence of stress induced burnout among cataract surgeons. We believe that knowledge of these factors can help formulate a solution to this underreported problem.

Methods: A three-part nationwide cross-sectional survey was disseminated with via the Royal College of Ophthalmologists (RCOphth) in the United Kingdom(UK).

Risk factors for having diabetic retinopathy at first screening in persons with type 1 diabetes diagnosed under 18 years of age.

Objective: To determine the risk factors for having diabetic retinopathy (DR) in children and young people (CYP) with type 1 diabetes (T1DM) at first screening.

Methods: Records from the Diabetes Eye Screening Wales (DESW) service for people in Wales, UK, with T1DM diagnosed under age 18 years were combined with other electronic health record (EHR) data in the Secure Anonymised Information Linkage (SAIL) Databank. Data close to the screening date were collected, and risk factors derived from multivariate, multinomial logistic regression modelling.

Genotype-phenotype correlation at codon 1740 of SETD2.

The SET domain containing 2, histone lysine methyltransferase encoded by SETD2 is a dual-function methyltransferase for histones and microtubules and plays an important role for transcriptional regulation, genomic stability, and cytoskeletal functions. Specifically, SETD2 is associated with trimethylation of histone H3 at lysine 36 (H3K36me3) and methylation of α-tubulin at lysine 40. Heterozygous loss of function and missense variants have previously been described with Luscan-Lumish syndrome (LLS), which is characterized by overgrowth, neurodevelopmental features, and absence of overt congenital anomalies.

Heterochromia irides and mistaken identity of retinoblastoma.

Retinoblastoma is the most common intraocular malignancy of infancy which frequently manifests with a white pupillary reflex. We report a case of delayed presentation of a child with retinoblastoma in his left eye because parents thought the change in iris colour in this eye was due to the innocent heterochromia irides that was previously diagnosed in his elder sibling. This late presentation necessitated enucleation of the affected eye followed by chemotherapy.

Is the severity of refractive error dependent on the quantity and extent of retinal laser ablation for retinopathy of prematurity?

Background/aim: To test the hypothesis severity of acquired refractive error in Retinopathy of Prematurity (ROP) is dependent on the quantity of laser treatment delivered.

Methods: Two groups (treated and untreated infants) were age and weight matched. Data on the number of laser burns and Retcam II retinal images were analysed using computer aided design software to determine the proportion of area treated.

Fresh frozen plasma (Octaplas) and topical heparin in the management of ligneous conjunctivitis.

Ligneous conjunctivitis is a rare form of chronic recurrent membranous conjunctivitis with reduced plasminogen activity. It is characterized by the formation of characteristic firm ("woody") membranes on the tarsal conjunctiva. Similar lesions may occur on other mucous membranes.

Abusive head trauma and the triad: a critique on behalf of RCPCH of 'Traumatic shaking: the role of the triad in medical investigations of suspected traumatic shaking'.

The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice.

Altered ratios of pro- and anti-angiogenic VEGF-A variants and pericyte expression of DLL4 disrupt vascular maturation in infantile haemangioma.

Infantile haemangioma (IH), the most common neoplasm in infants, is a slowly resolving vascular tumour. Vascular endothelial growth factor A (VEGF-A), which consists of both the pro- and anti-angiogenic variants, contributes to the pathogenesis of IH. However, the roles of different VEGF-A variants in IH progression and its spontaneous involution is unknown.

Congenital glaucoma in Wagner syndrome.

Wagner syndrome is a rare inherited vitreoretinopathy. We describe 3 related patients with Wagner syndrome who presented with congenital glaucoma at age 3 months and required multiple surgical interventions to control their intraocular pressure. All experienced visual loss and glaucomatous optic neuropathy.

Newborn retinal hemorrhages: a systematic review.

Purpose: To systematically review the characteristics, prevalence, evolution, and obstetric associations of retinal hemorrhages (RH) in newborns.

Methods: A systematic review, searching 10 databases (1970-2011), identified 45 studies, which underwent two independent reviews via the use of standardized critical appraisal. Studies meeting the following criteria were included: examination by an ophthalmologist, use indirect ophthalmoscopy, and first examination conducted within 96 hours of birth and before hospital discharge.

Development and validation of a standardized tool for reporting retinal findings in abusive head trauma.

Purpose: To develop and validate a robust standardized reporting tool for describing retinal findings in children examined for suspected abusive head trauma.

Design: A prospective interobserver and intraobserver agreement study.

Method: An evidence-based assessment pro forma was developed, recording hemorrhages (location, layer, severity) and additional features.

Validity and ease of use of a computerized Hess chart.

Purpose: To investigate agreement between computerized and conventional methods for obtaining Hess charts and to compare relative ease of use of both methods.

Methods: Hess charts of 65 patients were obtained by the use of the computerized Assaf Ocular Motility Analyzer (OMA) and the conventional Lees screen method. The Hess charts produced by each method were compared with a previously described scoring system.

A survey of the management of globe perforation during strabismus surgery in the United Kingdom.

Introduction: Globe perforation is a potentially devastating complication of strabismus surgery. The purpose of this study is to investigate the management of suspected globe perforation encountered during strabismus surgery in the United Kingdom.

Methods: A postal survey of all consultant ophthalmologists in the United Kingdom was undertaken.

Opaque intraocular lens for intractable diplopia-UK survey.

Aims: To assess the practice of the use of an opaque intraocular lens (IOL) for intractable diplopia in the UK.

Methods: A questionnaire was sent to 892 consultant ophthalmologists in practice requesting information on the treatment of intractable diplopia with an opaque IOL. Respondents were asked whether they would consider using an opaque IOL for intractable diplopia.

Ocular findings in pediatric patients with partial agenesis of corpus callosum.

Purpose: To evaluate the ocular associations with corpus callosum agenesis.

Methods: All children who had corpus callosum agenesis diagnosed by computed tomography or magnetic resonance imaging scans during a 10-year period were included in the study. A complete ophthalmological assessment was undertaken.

Spontaneous resolution of stage 4B retinopathy of prematurity.

An unfavorable outcome occurs in 31% of cases of treated severe threshold retinopathy of prematurity (ROP) and includes a retinal detachment of the posterior pole. Early treatment with laser of high risk prethreshold or type 1 ROP has significantly reduced this complication. However, despite prompt laser treatment, retinal detachments continue to be seen.