Inter-Ocular Fixation Instability of Amblyopia: Relationship to Visual Acuity, Strabismus, Nystagmus, Stereopsis, Vergence, and Age.

Purpose: Amblyopia damages visual sensory and ocular motor functions. One manifestation of the damage is abnormal fixational eye movements. Tiny fixation movements are normal; however, when these exceed a normal range, the behavior is labeled "fixation instability" (FI).

Prevalence of the Infantile Strabismus Complex in Premature Children With and Without Periventricular Leukomalacia.

Purpose: To determine whether rates of strabismus and associated visuomotor deficits differed among children with different severities of periventricular leukomalacia (PVL).

Design: Retrospective, case-control study.

Methods: Brain magnetic resonance images (MRI) obtained from 98 children aged ≥2 years were analyzed using a standardized scoring system: 67 of 98 had PVL (mean GA 31 weeks) and 31 of 98 did not have PVL (mean GA 29 weeks).

Vitamin B deficiency with normal plasma levels of pyridoxal 5'-phosphate in perinatal hypophosphatasia.

Pyridoxal 5'-phosphate (PLP), the principal circulating form of vitamin B (B), is elevated in the plasma of individuals with hypophosphatasia (HPP). HPP is the inborn-error-of-metabolism caused by loss-of-function mutation(s) of ALPL, the gene that encodes the "tissue-nonspecific" isoenzyme of alkaline phosphatase (TNSALP). PLP accumulates extracellularly in HPP because it is a natural substrate of this cell-surface phosphomonoester phosphohydrolase.

Parental Assessment of Status of Congenital Upper Limb Differences: Analysis of the Pediatric Outcomes Data Collection Instrument.

Purpose: To determine the range of the Pediatric Outcomes Collection Instrument (PODCI) scores for children with a wide variety of congenital upper limb differences and to examine the scoring effect of the patient's surgical history, family history, severity of involvement, and syndromic associations.

Methods: We reviewed the PODCI scores for 109 patients, aged 2-18 years, treated for nontraumatic upper extremity conditions. Charts were reviewed for sex, age, extent of limb involvement, laterality, family history, surgical history, and syndrome association.

Synpolydactyly of the hand: a radiographic classification.

Unlabelled: Synpolydactyly is an uncommon congenital anomaly characterized by polydactyly with syndactyly in the central hand. The purpose of this investigation was to develop and assess the reliability of a radiographic classification system for synpolydactyly. We identified 56 hands with central synpolydactyly and developed a radiographic classification system that categorizes by the location within the hand, the bony level of polydactyly, and the presence of a delta phalanx.

Defining Features of the Upper Extremity in Holt-Oram Syndrome.

Purpose: To investigate the distinguishing morphological characteristics of children with radial longitudinal deficiency (RLD) in Holt-Oram syndrome (HOS).

Methods: One hundred fourteen involved extremities in 62 patients with a diagnosis of HOS were identified at 3 institutions. Medical records and radiographs were evaluated.

The effect of soft tissue distraction on deformity recurrence after centralization for radial longitudinal deficiency.

Purpose: To assess recurrence and complications in children with radial longitudinal deficiency treated with or without external fixator soft tissue distraction prior to centralization.

Methods: Thirteen upper extremities treated with centralization alone were compared with 13 treated with ring fixator distraction followed by centralization. Resting wrist position between the 2 groups was compared before surgery, approximately 2 years after surgery (midterm), and at final follow-up, which was at a mean of 10 years for the centralization-alone group and 6 years for the distraction group.

Surgical and nonsurgical treatment of cubital tunnel syndrome in pediatric and adolescent patients.

Purpose: Few studies have investigated the presence or treatment of cubital tunnel syndrome in pediatric or adolescent patients. We conducted this retrospective investigation to quantify success rates of nonsurgical care and to assess patient outcomes after surgical intervention.

Methods: We identified 39 extremities treated for cubital tunnel syndrome between 2000 and 2009 at one institution.

Persistently recurrent infantile esotropia.

Introduction: Children with infantile esotropia often require more than one surgery to align the eyes horizontally, for either recurrent esotropia or consecutive exotropia. We report an unusual subset of patients who had persistently recurrent esotropia despite multiple surgeries.

Methods: The records of 11 patients who presented before age one year with infantile esotropia and who had three or more surgeries for recurrent esotropia were reviewed.

Surgical correction of clinodactyly: two straightforward techniques.

Clinodactyly, a deviation of the thumb or finger in the coronal plane, is rarely functionally limiting and in most cases is treated nonoperatively. Those with functional limitations, typically associated with angulation greater than 25 degrees, may benefit from surgical correction. We have used 2 different surgical procedures, a physiolysis in younger children and an opening-wedge osteotomy in older children, to manage this deformity in selected children with a functional limitation.

Phakic intraocular lens correction of high ametropia in children with neurobehavioral disorders.

Purpose: A subset of children with high ametropia and neurobehavioral disorders have chronic difficulties with spectacle or contact lens wear. We report the results of refractive surgery in a series of these children treated using bilateral or unilateral phakic intraocular lenses (IOLs) for ametropia >10 D.

Methods: Clinical course and outcome data were collated prospectively in a group of 12 children (mean age, 10.

Effect of preoperative stability of alignment on outcome of strabismus surgery for infantile esotropia.

Introduction: Some strabismus surgeons wait until the angle of deviation stabilizes prior to operating on patients with infantile esotropia. This study evaluated whether a preoperative increase in the angle of deviation affected surgical outcomes.

Methods: This was a retrospective comparative case series in which records of patients with infantile esotropia, who had surgery performed before age 2 years and who were followed for at least 2 years postoperatively, were reviewed to identify two groups for comparison: the first had /=10(Delta) increase in the angle of deviation prior to surgery.

Outcomes in children with nasolacrimal duct obstruction: Significance of persistent symptoms while stents are in place.

To evaluate the correlation between persistent symptoms while stents are in place and final outcome in children with nasolacrimal duct obstruction (NLDO). A retrospective observational case series, with medical record review that included indications for surgery, surgical procedure, presence of symptoms while stents were in place, and final outcome after stent removal. Twenty-eight children with NLDO had nasolacrimal duct stents placed in 42 eyes.

Unilateral lens extraction for high anisometropic myopia in children and adolescents.

Introduction: A subpopulation of children with anisometropic myopia, amblyopia, and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated using lensectomy alone (clear lens extraction) or lensectomy with simultaneous implantation of an intraocular lens (refractive lens exchange).

Methods: Clinical course and outcome data were collated retrospectively in a group of 7 children and adolescents (mean age, 9.

Refractive surgery for high bilateral myopia in children with neurobehavioral disorders: 2. Laser-assisted subepithelial keratectomy (LASEK).

Introduction: A subpopulation of children with high myopia and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated bilaterally using excimer laser technology.

Methods: Clinical course and outcome data were collated prospectively in a group of 9 children (mean age, 10.

Refractive surgery for high bilateral myopia in children with neurobehavioral disorders: 1. Clear lens extraction and refractive lens exchange.

Introduction: A subpopulation of children with high myopia and neurobehavioral disorders is noncompliant with spectacle wear and ill-suited to correction using contact lenses. We report the results of refractive surgery in a series of these children treated using lensectomy alone (clear lens extraction), or lensectomy with simultaneous implantation of an intraocular lens (refractive lens exchange).

Methods: Clinical course and outcome data were collated prospectively in a group of 13 children (mean age 10.

Risk of retinopathy in children with type 1 diabetes mellitus before 2 years of age.

Purpose: To assess the risk of diabetic retinopathy (DR) in children with type 1 diabetes mellitus (T1DM) diagnosed at a very early age.

Design: Observational case series.

Methods: The records of 51 patients were identified through the diabetes database of the Division of Pediatric Endocrinology and Metabolism at Washington University School of Medicine.

The effect of initial recognition of abnormalities by physicians on outcome of retinoblastoma.

Purpose: The purpose of this study was to assess the effect of early diagnosis by physicians on outcome of retinoblastoma.

Methods: This was an observational case series in which the records of 36 patients with retinoblastoma were reviewed. The age at onset of first symptoms and diagnosis, identity of the individual who first recognized an abnormality, treatment, and outcome were analyzed.

Correction of large amblyopiogenic refractive errors in children using the excimer laser.

Purpose: We sought to determine whether laser subepithelial keratomileusis (LASEK) and photorefractive keratectomy (PRK) are effective methods for correcting amblyopiogenic refractive errors in children.

Methods: Thirty-six eyes in 35 amblyopic children, who ranged in age from 4 to 16 years (mean, 8.4 years), received treatment for large magnitude ametropia.

Pediatric lung transplantation: update 2003.

In the past 15 years there have been more than 1200 pediatric lung and heart-lung transplants worldwide. This article regarding the current status of pediatric lung transplantation describes indications, outcomes, and complications, with particular emphasis on issues specific to pediatrics, including growth. Information useful to the pediatrician and pediatric pulmonologist is also included.

Balloon catheter dilation for treatment of older children with nasolacrimal duct obstruction.

Objectives: To describe the outcomes of balloon catheter dilation of the lacrimal duct as the first surgical treatment for older children (>or=18 months) with nasolacrimal duct (NLD) obstruction and to examine the effect of the type of obstruction on outcome.

Design: Retrospective noncomparative case series.

Participants: Seventy-six children 18 months or older with NLD obstruction who had not undergone previous surgery.

Effects of extraocular muscle tenotomy on congenital nystagmus in macaque monkeys.

Introduction: Extraocular muscle tenotomy has been reported to damp congenital nystagmus in an achiasmatic sheepdog. We performed extraocular muscle tenotomy to evaluate its effects on congenital nystagmus in primates.

Methods: Magnetic search coil eye movement recordings were used to document the presence of horizontal congenital nystagmus in 2 adult macaque monkeys that also had naturally occurring infantile strabismus.

Balloon catheter dilation for treatment of persistent nasolacrimal duct obstruction.

Purpose: To report the outcome of balloon catheter dilation of the lacrimal duct for treatment of children with persistent nasolacrimal duct obstruction after previous surgery.

Design: Interventional case series.

Methods: Thirty-two consecutive children with a history of persistent nasolacrimal duct obstruction following previous surgery were treated with nasolacrimal duct probing with balloon catheter dilation of the distal nasolacrimal duct.

Retinal and intraventricular cerebral hemorrhages in the preterm infant born at or before 30 weeks' gestation.

Purpose: To determine the prevalence of retinal hemorrhages and their association with cerebral intraventricular hemorrhages (IVH) in low-birth-weight preterm neonates born at or before 32 weeks' gestation.

Methods: We prospectively studied a consecutive series of 22 neonates (24-30 weeks' gestation; mean gestational age, 27 weeks; mean weight, 1065 g) admitted to the neonatal intensive care unit. Anterior segment and indirect ophthalmoscopic examination, as well as cranial ultrasonographic examination, were performed on day 1 and day 10 of life.