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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Posterior lenticonus is associated with progressive lens opacification. We report a series of 40 consecutive patients (41 eyes) with posterior lenticonus who were treated by three pediatric ophthalmologists between 1974 and 1988. Prior to cataract surgery, appropriate patients were treated with atropine dilatation, spectacle correction including bifocals for refractive errors, and amblyopia occlusion therapy. Indications for surgery were a measured decrease in visual acuity, the loss of a central fixation reflex, or the onset of strabismus. The age at which cataract surgery was performed ranged from 2 months to 12 years (mean 4 years, 6 months). Nineteen eyes (49%) achieved postoperative acuities in the 20/20 to 20/40 range, 7(18%) eyes achieved 20/50 to 20/100, 4 (10%) eyes achieved 20/200, and 4 (10%) eyes achieved less than 20/200. Two (5%) young patients had central, steady, and maintained visual fixation reflexes and 3 (8%) additional patients had central, steady, but not maintained reflexes. After cataract surgery and aphakic optical correction, amblyopia was present in 84% of patients and strabismus was present in 51% of patients. The patients in this study had sufficient optical distortion to produce amblyopia. Cataract removal and optical correction alone did not correct the vision; occlusion therapy for amblyopia was required. Earlier surgery may be indicated to prevent visual deprivation amblyopia in patients with posterior lenticonus.
J Pediatr Ophthalmol Strabismus
PMID:Management of posterior lenticonus. 189 May 71

A patient with acquired esotropia underwent apparently successful strabismus surgery. Subsequent recurrence of esotropia, associated with square-wave jerks and downbeat nystagmus led to further investigation. Although standard CT scan was normal, rescanning after instillation of metrizamide demonstrated a Chiari I malformation. Posterior fossa decompression alleviated the esotropia. Acquired esotropia has not been recognized as a manifestation of Chiari I malformation. Our case illustrates that a high degree of suspicion is required to make the diagnosis of Chiari I malformation. Specialized techniques, such as metrizamide cisternography, or magnetic resonance imaging may be necessary if routine diagnostic measures are unrevealing.
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PMID:Acquired esotropia. A manifestation of Chiari I malformation. 623 49

I performed a posterior fixation of the medial rectus in seven patients with convergence excess esotropia and successfully reduced their esotropia at near. Postoperative saccadic velocity testing did not reveal the expected decrease in saccadic velocity as the eye moved increasingly into the field of action of the operated muscle. Posterior fixation of a rectus muscle may enhance the effect of the standard recession operation by increasing the amount of slack created in the functional part of the muscle after recession. Also, it may make a large percentage of the muscle fibers ineffective.
J Pediatr Ophthalmol Strabismus
PMID:Evaluation of the posterior fixation plus recession operation with saccadic velocities. 663 53

We characterized the regression pattern of retinopathy of prematurity (ROP) for 266 infants examined over a 22-month period. Infants were included in the evaluation with a birth weight of less than or equal to 1500 g. Regression of retinopathy was observed in all but 11 infants, who were treated for threshold ROP. ROP limited to the peripheral retina resolved around term (40 weeks postconceptional age). Posterior ROP and/or stage 3 ROP underwent a protracted course of resolution, often not reaching zone 3 until 42 to 45 weeks after conception. Permanent retinal/vascular sequelae of ROP were observed in 10% of infants with ROP. The most common abnormality was failure to completely vascularize the temporal retinal periphery. Overall, retinal morbidity from ROP was an infrequent occurrence (18 of 266 premature infants--6.8%).
J Pediatr Ophthalmol Strabismus
PMID:Regression pattern in retinopathy of prematurity. 793 51

We compared 23 patients (ages 4 to 18 years) who were receiving long-term oral prednisone therapy with 31 normal controls (ages 7 to 16 years). Indications for corticosteroid treatment included renal transplant in 11 patients, nephrotic syndrome in 7, glomerulonephritis in 4, and vasculitis without renal disease in 1. The mean duration of prednisone therapy was 5.0 +/- 3.5 years, and the mean dose at the time of examination was 0.29 +/- 0.18 mg/kg/day. Mean intraocular pressure was 16.0 +/- 3.0 mm Hg (range, 12 to 25 mm Hg) in the prednisone group and 15.4 +/- 2.1 mm Hg (range, 12 to 20 mm Hg) in the control group. The difference between the means was 0.6 mm Hg (P = 0.35). Posterior subcapsular cataracts were present in seven (30%) of the prednisone patients, but in none of the controls (P = .001). None of the cataracts were visually significant. We found no evidence that pediatric patients on long-term, low-dose prednisone have higher intraocular pressures (IOPs) than normal children, although they are more likely to develop posterior subcapsular cataracts.
J Pediatr Ophthalmol Strabismus
PMID:Ocular implications of long-term prednisone therapy in children. 835 Feb 20

Posterior lenticonus is an uncommon abnormality in the shape of the crystalline lens, characterized by a spheroidal or conical protuberance affecting the posterior lens surface. It may be unilateral or bilateral. A male infant with bilateral posterior lenticonus is described, whose mother was found to have bilateral sutural cataracts. The association of cataracts with posterior lenticonus and the genetics of the condition are discussed.
J Pediatr Ophthalmol Strabismus
PMID:Posterior lenticonus: clinical patterns and genetics. 763 92

Infantile esotropia with nystagmus in abduction is characterized by early onset, jerk nystagmus in abduction, and dissociated vertical deviation, among other features. Electro-oculographic tracings present easily recognizable patterns both in saccadic and pursuit movements. Visual evoked responses are asymmetric in most cases and optokinetic nystagmus is invariably asymmetric. Visual cortex maldevelopment seems to play a major pathogenic role. Recent findings in myelomeningocele and in patients with posterior fossa tumors suggest that pathological alterations in this area may tend to induce similar anomalies in electro-oculographic and optokinetic nystagmus recordings. Posterior fossa damage or impairment is therefore suspected to be a possible causative factor in the development of infantile esotropia with nystagmus in abduction.
J Pediatr Ophthalmol Strabismus
PMID:On infantile esotropia with nystagmus in abduction. 853 Oct 31

Posterior lenticonus is a protrusion of the posterior capsule and cortex into the vitreous. The etiology is widely debated because of the rare nature of the condition. Lenticonus can present with concurrent ocular conditions, which can disrupt normal visual development. Currently, the only treatment option for posterior lenticonus is lensectomy, which may still have a reduced chance of visual success secondary to the associated disease. Although strabismus and amblyopia are commonly associated, keratoconus has not previously been reported with unilateral posterior lenticonus. Considering treatment of the associated condition may allow the patient to delay or forego surgical intervention.
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PMID:Treatment options for concurrent ocular disease presenting with posterior lenticonus. 970 34

Posterior chamber intraocular lenses are a well-accepted treatment of aphakia in children 2 years of age and older, with many now considering them as the treatment of choice. Infants, however, are usually treated with contact lens, rather than intraocular lens implantation, as the infant eye undergoes significant axial elongation. The use of intraocular lenses in children with cataracts associated with juvenile rheumatoid arthritis remains controversial, but a recent article [9] describes good results in these patients, who historically have a poor prognosis. The management of amblyopia associated with unilateral congenital cataracts is evolving. In the 1970s and 1980s, full-time occlusion of the sound eye was advocated for infants with unilateral congenital cataracts. It was also taught that binocular fusion was impossible to obtain, and children with unilateral cataracts inevitably develop strabismus. Recent studies have shown that part-time occlusion may in fact yield better results, allowing the development of binocular vision and stereopsis and reducing the incidence of strabismus.
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PMID:Pediatric cataracts. 1016 74

Proprioceptive receptors have long been known anatomically to be present in extraocular muscles, specifically at the myotendinous junction. Their function in regulating smooth pursuits is experimentally demonstrated. The clinical significance of this for strabismus is still unknown. Esotropia surgery before resolution of moderate amblyopia is not detrimental. Botulinum toxin injections will correct infantile esotropia but require more anesthesia sessions overall than does conventional surgery, increasing cost. Late-onset comitant esotropia is usually refractive in nature and rarely neurologic. Comitant esodeviation is also prevalent in children with known neurologic insults. In both situations, it is the associated neurologic signs that point to the underlying neurologic cause. Posterior fixation suture will correct a high accommodative convergence/accommodation ratio esotropia. Exotropia negatively affects patients' quality of life. Surgical outcomes differ in patients whose angle of deviation increases with 1 hour of occlusion testing at extreme distances ("outdoor sensitivity"). Recession resection influences the distance and near angles of deviation equally whereas bilateral lateral rectus resection influences the distance deviation more than the near. Spray administration of cycloplegic agents to closed eyelids has been shown to be as effective as administration of eye drops. The spray is much better tolerated by patients and easier to administer. Photorefraction, although not yet effective as a screening tool, is useful to document alignment and refractive errors.
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PMID:Comitant strabismus. 1038 75


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