Treatment of nasolacrimal duct obstruction in children with trisomy 21.

Background: Nasolacrimal duct (NLD) obstruction and tear film abnormalities occur frequently in children with trisomy 21. This study describes the outcomes of treatment for NLD obstruction in this population.

Methods: The records of 15 children with trisomy 21 treated for NLD obstruction were reviewed.

Anomalous retinal correspondence: neuroanatomic mechanism in strabismic monkeys and clinical findings in strabismic children.

Background: Anomalous retinal correspondence (ARC) is a neural adaptation to eye misalignment in which non-corresponding retinal points are linked in the visual cortex to provide binocular fusion. ARC within the striate cortex would require that horizontal neurons link right-eye and left-eye ocular dominance columns (ODCs) separated by a distance in the cortex proportional to the angle of strabismus. Two hypothetical mechanisms are possible: (1) The ODCs can be linked by axons of horizontal neurons that project monosynaptically from a right-eye to a left-eye ODC.

Asymmetric motion visually evoked potentials in infantile strabismus are not an artifact of latent nystagmus.

Background: Patients who have infantile strabismus exhibit a directional asymmetry of motion visually evoked potentials (MVEPs) recorded under conditions of monocular viewing. The majority of these patients also have latent nystagmus, raising the possibility that the MVEP asymmetry is an artifact of the nystagmus. To explore this issue, we correlated MVEPs and eye movements under conditions that eliminated or increased latent nystagmus.

The effect of surgeon experience on velopharyngeal functional outcome following palatoplasty: is there a learning curve?

There is little information in the cleft palate literature concerning the relationship between surgeon volume and clinical outcomes. It is unknown whether such a relationship applies specifically to velopharyngeal dysfunction and the need for secondary physical management of the velopharynx. The purpose of this paper was to explore the concept of an operative learning curve for different surgeons with respect to palatoplasty.

Surgery for esotropia with a high accommodative convergence/accommodation ratio: effects on accommodative vergence and binocularity.

Background And Objective: To determine the effectiveness of strabismus surgery as an alternative treatment for high accommodative convergence/accommodation (AC/A) ratio (nonrefractive accommodative) esotropia.

Patients And Methods: Twenty-three consecutive children with an AC/A ratio of 5:1 or greater and a distance-near disparity of 10 prism diopters (PD) or more were studied in a prospective design. Each patient was treated by recession of both medial rectus muscles for the full amount of esotropia measured at near fixation through the full distance hyperopic correction.

Absence of subcortical pathway optokinetic eye movements in an infant with cortical blindness.

Tracking of large visual targets by normal neonates and by infants with visual cortex damage has led to the suggestion that infants use subcortical vision to guide visuomotor behaviors. To test this assertion, the author recorded eye movements in a five-month-old infant who became cor-tically-blind following an anoxic episode. Use of a full-field, high-contrast visual stimulus failed to elicit any evidence of optokinetic nystagmus.

Late hydrocephalus after arrest and resolution of neonatal post-hemorrhagic hydrocephalus.

This report describes the occurrence of rapid progression of hydrocephalus after discharge from the nursery in four of 48 infants who had had previous arrest of progression of post-hemorrhagic hydrocephalus, and at least partial resolution of ventriculomegaly. This later-onset hydrocephalus occurred at a mean age of seven months; the most consistent presenting clinical feature was rapid head growth. Three of the four infants required a ventriculo-peritoneal shunt and the fourth was treated with acetazolamide, with apparent resolution of the hydrocephalus.