Speciality
Spotlight

 




 


Ophthalmology


 

 





Strabismus

   

  • Tin K J Chan, Arthur L Rosenbaum, Rajesh Rao, et al (Univ of California, Los Angeles, CA, USA)

    Indocyanine green angiography of the anterior segment in patients undergoing strabismus surgery.

    Br.J. Ophthalmol. Feb.2001; 85: 214-218.

       

    Imaging of the anterior segment using conventional fluorescein angiography is suitable only in lightly pigmented irides as the brown pigmentation of the iris masks fluorescein transmission.

      

    Indocyanine green (ICG) angiography has excellent penetration of pigment epithelium and hence has potential application in detecting perfusion changes of dark irides after strabismus surgery.

       

    With the advent of digitalized imaging, ICG angiography is useful for studying the choroidal
    vasculature.

       
  • SE Dorey, GGW Adams, et al (Moorfields Eye Hospital, UK)

    Intensive occlusion therapy for amblyopia

    Br J Ophthalmol March 2001, 85: 310-313

       

    This is a retrospective study of 39 children admitted to a paediatric ophthalmic ward for five days of supervised intensive occlusion therapy. These patients had previously failed to respond to outpatient occlusion.

      

    67% gained at least one line of visual acuity in their amblyopic eye. 13% gained 3 or more lines of the Snellen’s chart.

       

    Intensive occlusion, under supervision is only possible during in patient treatment, even in children where occlusion failed earlier during outpatient management.

       
  • Recchia
    FM, Baumal CR, et al (Thomas Jefferson Univ,
    Philadelphia; New England Eye Ctr, Boston)

    Endophthalmitis After Pediatric Strabismus
    Surgery


    Arch Ophthalmol 118: 939-944, 2000

       

    The authors describe the clinical findings and final
    outcomes of 6 patients with pediatric
    endophthalmitis (PE) over a 15-year period.

      

    A retrospective review was conducted of the initial
    signs, clinical findings, culture results, treatment
    and visual and anatomical outcomes for 6 children
    treated for PE between 1983 and 1998.

      

    4 boys and 2 girls ranged in age from 8 months to
    six years. In all cases, lethargy and asymmetric eye
    redness with or without lid oedema or fever
    developed within 4 days of strabismus surgery.
    Periorbital swelling, redness and leukocoria caused
    by vitritis were seen. Hypopyon was seen in some
    patients.

      

    All patients underwent pars plana vitrectomy and
    received intravitreal and systemic antibiotics.
    Streptococcus pneumoniae, Haemophilus influenzae and
    Staphylococcus aureus were grown on vitreous
    cultures.

      

    Within 6 months of strabismus surgery, there was no
    light perception in any of the 6 eyes (3 of which
    had to be enucleated). The use of preoperative
    prophylaxis with topical povidone-iodine solution is
    recommended.

       

  • Young
    TL, Conahan BM, et al (Univ of Minnesota,
    Minneapolis; Creighton Univ, Omaha, Neb)

    Anterior Transposition of the Superior Oblique
    Tendon in the Treatment of Oculomotor Nerve Palsy
    and Its Influence on Postoperative Hypertropia


    J Pediatr Ophthalmol Strabismus 37: 149-155, 2000

      

    In a patient with severe IIIrd nerve palsy, the
    affected eye is aligned in a characteristically
    abducted and depressed position due to the unopposed
    action of the lateral rectus and superior oblique.

      

    In a retrospective review 8 patients were found with
    IIIrd nerve palsy. They had undergone anterior
    transposition of the superior oblique tendon,
    without trochleotomy or vertical rectus muscle
    surgery.

      

    The superior oblique tendon was cut at the medial
    border of the superior rectus muscle in each patient
    and placed 1 mm to 3.5 mm anterior to the medial
    insertion of the superior rectus muscle in all
    patients. The lateral rectus was weakened. There was
    no resection of the vertical recti.

      

    In this way alignment of the eyes in the primary
    position of gaze was improved. None of the patients
    experienced significant postoperative restrictive
    hypertropia or new postoperative paradoxical ocular
    movements.

            

 



 

 

Speciality Spotlight

 

 

Strabismus
   

  • Tin K J Chan, Arthur L Rosenbaum, Rajesh Rao, et al (Univ of California, Los Angeles, CA, USA)
    Indocyanine green angiography of the anterior segment in patients undergoing strabismus surgery.
    Br.J. Ophthalmol. Feb.2001; 85: 214-218.
       
    Imaging of the anterior segment using conventional fluorescein angiography is suitable only in lightly pigmented irides as the brown pigmentation of the iris masks fluorescein transmission.
      
    Indocyanine green (ICG) angiography has excellent penetration of pigment epithelium and hence has potential application in detecting perfusion changes of dark irides after strabismus surgery.
       
    With the advent of digitalized imaging, ICG angiography is useful for studying the choroidal vasculature.
       
  • SE Dorey, GGW Adams, et al (Moorfields Eye Hospital, UK)
    Intensive occlusion therapy for amblyopia
    Br J Ophthalmol March 2001, 85: 310-313
       
    This is a retrospective study of 39 children admitted to a paediatric ophthalmic ward for five days of supervised intensive occlusion therapy. These patients had previously failed to respond to outpatient occlusion.
      
    67% gained at least one line of visual acuity in their amblyopic eye. 13% gained 3 or more lines of the Snellen’s chart.
       
    Intensive occlusion, under supervision is only possible during in patient treatment, even in children where occlusion failed earlier during outpatient management.
       
  • Recchia FM, Baumal CR, et al (Thomas Jefferson Univ, Philadelphia; New England Eye Ctr, Boston)
    Endophthalmitis After Pediatric Strabismus Surgery
    Arch Ophthalmol 118: 939-944, 2000
       
    The authors describe the clinical findings and final outcomes of 6 patients with pediatric endophthalmitis (PE) over a 15-year period.
      
    A retrospective review was conducted of the initial signs, clinical findings, culture results, treatment and visual and anatomical outcomes for 6 children treated for PE between 1983 and 1998.
      
    4 boys and 2 girls ranged in age from 8 months to six years. In all cases, lethargy and asymmetric eye redness with or without lid oedema or fever developed within 4 days of strabismus surgery. Periorbital swelling, redness and leukocoria caused by vitritis were seen. Hypopyon was seen in some patients.
      
    All patients underwent pars plana vitrectomy and received intravitreal and systemic antibiotics. Streptococcus pneumoniae, Haemophilus influenzae and Staphylococcus aureus were grown on vitreous cultures.
      
    Within 6 months of strabismus surgery, there was no light perception in any of the 6 eyes (3 of which had to be enucleated). The use of preoperative prophylaxis with topical povidone-iodine solution is recommended.
       

  • Young TL, Conahan BM, et al (Univ of Minnesota, Minneapolis; Creighton Univ, Omaha, Neb)
    Anterior Transposition of the Superior Oblique Tendon in the Treatment of Oculomotor Nerve Palsy and Its Influence on Postoperative Hypertropia
    J Pediatr Ophthalmol Strabismus 37: 149-155, 2000
      
    In a patient with severe IIIrd nerve palsy, the affected eye is aligned in a characteristically abducted and depressed position due to the unopposed action of the lateral rectus and superior oblique.
      
    In a retrospective review 8 patients were found with IIIrd nerve palsy. They had undergone anterior transposition of the superior oblique tendon, without trochleotomy or vertical rectus muscle surgery.
      
    The superior oblique tendon was cut at the medial border of the superior rectus muscle in each patient and placed 1 mm to 3.5 mm anterior to the medial insertion of the superior rectus muscle in all patients. The lateral rectus was weakened. There was no resection of the vertical recti.
      
    In this way alignment of the eyes in the primary position of gaze was improved. None of the patients experienced significant postoperative restrictive hypertropia or new postoperative paradoxical ocular movements.
            

 

 

By |2022-07-20T16:42:04+00:00July 20, 2022|Uncategorized|Comments Off on Strabismus

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