pediatric optometry

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BACKGROUND: Peripapillary hyperreflective ovoid masslike structures (PHOMS) are now considered a common cause of pseudopapilledema in the pediatric population. METHODS: The medical records of all patients ≤18 years of age with PHOMS, confirmed on optical coherence tomography, seen at single pediatric neuro-ophthalmology clinic between 2017 and 2021 were reviewed retrospectively. RESULTS: A total of 47 patients (35 females), with median age of 12...

PURPOSE: To determine and analyze the 100 most cited articles in pediatric ophthalmology. METHODS: A literature search was conducted using the ISI Web of Science database on the top 100 most cited articles in pediatric ophthalmology. RESULTS: The 100 most cited articles were published between 1941 and 2018, with the greatest number published in both 2005 and 2012. A total of 29,731 citations were generated during the study period. There has been a significant increase in citations annually since 1941, with a peak number of citations in 2021 with 2,629 citations...

Background: A same day admission approach was established for pediatric patients undergoing elective surgery owing to an increase in demand for bed availability and the need for medical, logistical, psychological, and fiscal improvements. This study aimed to assess the effectiveness of the same day admission approach for reducing demand for preoperative bed occupancy in pediatric inpatient units. Method: Data on elective surgery patients considered for same day admission were prospectively collected in an Excel spreadsheet...

Purpose: Functional visual impairment in children is mostly caused by amblyopia. Permanent visual impairment is caused by belated treatment of amblyopia and underlying causes, mostly due to the lack of awareness. Amblyopia affects children's school performance, social interaction and motor skills. This study was aimed to assess the profile of amblyopia among children aged from 5 to 15 years. Methods and Materials: A hospital-based, cross-sectional study was done from November to April 2020/21...

OBJECTIVES: To evaluate the validity of a smartphone-based application for visual acuity (VA) testing in children and to compare parent and clinician-performed VA to standard VA assessment. METHODS: A cohort of 100 children aged <18 years old was recruited. Subjects were randomly assigned to either start with conventional distance VA chart screening or the smartphone VA assessment twice by both the clinician and the caregiver if applicable. Near VA scores were assessed using the near vision E chart...

SIGNIFICANCE: When exploring relationships among clinical measures and patient-reported outcome measures in adults with convergence insufficiency, worse symptoms (Convergence Insufficiency Symptom Survey score) appeared to be correlated with worse Reading Function domain score (Adult Strabismus-20 quality-of-life questionnaire). After treatment, improved symptoms were associated with improved reading function quality of life. PURPOSE: To explore relationships between clinical measures and patient-reported outcome measures in adults undergoing treatment for symptomatic convergence insufficiency...

PURPOSE: Keratoconus (KC) is a bilateral and often asymmetric disease which can progress to corneal thinning and protrusion. Keratoconus in children appears to be more aggressive than in adults. Research on pediatric keratoconus is limited, and treatments rely on research and experience in adult populations. The current study aimed to provide an analysis on the distribution of the corneal tomography measurements in an underserved, Black and LatinX, primarily low-income pediatric population...

OBJECTIVE: In August 2018, Ontario introduced the Child Visual Health and Vision Screening Protocol outlining school-based senior kindergarten (aged 4-6 years) vision screening. We determine the prevalence of children at risk based on screening in an Ontario community and follow up to determine resource utilization after screening. METHODS: Vision screening data (HOTV, Randot, Autorefractor) from 41 schools (1127 children) were collected for the 2018-2019 and 2019-2020 school years...

OBJECTIVE: Craniosynostosis is characterized by the premature fusion of at least one cranial suture. Although evidence suggests that patients with both syndromic and nonsyndromic craniosynostosis may benefit from developmental, behavioral, and mental health support, data on utilization of healthcare services are lacking. In this study the authors compared utilization of mental health care, rehabilitation therapies, and other specialty medical services among children with craniosynostosis, children with plagiocephaly, and healthy controls...

SIGNIFICANCE: A rigorously designed and calibrated symptom questionnaire for childhood intermittent exotropia would be useful for clinical care and for research. PURPOSE: To Rasch-calibrate and evaluate the previously developed Child Intermittent Exotropia Symptom Questionnaire using data gathered as part of a randomized clinical trial. METHODS: The questionnaire was administered to 386 children ages 3 to 10 years old with Intermittent Exotropia who were enrolled in a randomized clinical trial comparing overminus to non-overminus spectacles...

BACKGROUND: Individuals who have suffered a concussion/mild traumatic brain injury (mTBI) frequently report symptoms associated with vestibular and/or oculomotor dysfunction (VOD) like dizziness, nausea, fatigue, brain fog, headache, gait and neurocognitive impairments which are associated with the development of chronic symptoms. The Vestibular/Ocular Motor Screening (VOMS) tool has been established as a reliable and clinically relevant complement to use alongside a battery of post-concussion tests to improve screening and referral for further evaluation and treatment of VOD...

SIGNIFICANCE: Neovascular glaucoma is an important subset of secondary glaucoma in neurofibromatosis patients. Vasculopathy of the ophthalmic circulation needs to be borne in mind while evaluating their etiology. PURPOSE: This study aimed to report the presentation, diagnostic work-up and management of an unusual case of neovascular glaucoma in a child. CASE REPORT: A 7-year-old boy presented with uniocular ischemic fundus and secondary neovascular glaucoma...

SIGNIFICANCE: Binocular treatment for unilateral amblyopia is an emerging treatment that requires evaluation through a randomized clinical trial. PURPOSE: To compare change in amblyopic eye visual acuity (VA) in children aged 4 to 6 years treated with the dichoptic binocular Dig Rush iPad game plus continued spectacle correction vs. continued spectacle correction alone. METHODS: Children (mean 5.7 years) were randomly assigned to home treatment for 8 weeks with the iPad game (n = 92, prescribed 1 hour/day, 5 days/week or continued spectacle correction alone n = 90) in a multi-center randomized clinical trial...

SIGNIFICANCE: Foveal avascular zone (FAZ) area is a frequently used biomarker in diseases impacting the retinal vasculature in pediatric populations. Variation in axial length between individuals results in differences in lateral image scale, which affect the accuracy of FAZ area measurements. Accordingly, changes in axial length over time within individual children would affect estimates of FAZ area change. PURPOSE: This study aimed to quantify how changes in axial length over time affect estimates of FAZ area change using optical coherence tomography angiography (OCT-A) images...

BACKGROUND: Infectious conjunctivitis is among the most common pediatric infections worldwide; antibiotics are often not indicated. We aimed to determine factors associated with ophthalmic antibiotic prescribing and changes in prescribing prior to and during the COVID-19 pandemic at a single center. METHODS: Encounters for children with infectious conjunctivitis from 2017 to 2020 at Denver Health and Hospital Authority clinics were analyzed retrospectively. Factors associated with prescribing were evaluated using multivariable logistic regression modeling...

SIGNIFICANCE: Cerebral visual impairment (CVI) is the leading cause of visual impairment in the developed world. Providing children with CVI with the appropriate treatment ensures the best possible visual outcome and potentially improves quality of life. PURPOSE: The purpose of this study was to determine physician prescribing and visual rehabilitation referral patterns in children with CVI. METHODS: A retrospective chart review was completed on children with CVI examined at Cincinnati Children's Hospital Medical Center from January 1, 2008, to March 1, 2018...

SIGNIFICANCE: Systemic corticosteroid use in children is rare because of known risks of adverse effects. The increased prevalence of multisystem inflammatory syndrome associated with COVID-19 may change this. It is critical for eye care providers to be aware of potential severe and rapid ocular hypertensive response to prevent irreversible vision loss. PURPOSE: The purpose of this study was to report the importance of early monitoring of intraocular eye pressure in pediatric patients on systemic steroid medication...

SIGNIFICANCE: Cranial nerve IV palsy is the most common cranial nerve affected in both pediatric and adult patients with vertical and/or torsional diplopia. The condition has multiple known etiologies, including schwannoma, which is rarely reported in the literature. Schwannoma should be considered when the most common etiologies have been ruled out. PURPOSE: This report documents a rare case of cranial nerve IV palsy secondary to a trochlear schwannoma. Treatment and management considerations will be discussed...

SIGNIFICANCE: This pilot study compared subjective and objective vision of children wearing single-vision and +2.00, +3.00, and +4.00 D add power soft multifocal contact lenses to determine whether the higher add power-thought to provide better myopia control-resulted in visual compromise. PURPOSE: This study aimed to determine the maximum add power children wearing center-distance soft multifocal contact lenses could accept objectively and subjectively. METHODS: Myopic children were assigned in random order to wear omafilcon A single-vision or multifocal "D" contact lenses with +2...