Journal Contents
| |||
Pediatrics and StrabismusIncomplete Presentations in a Series of 37 Children with Kawasaki Disease the Role of the Pediatric Ophthalmologist. Blatt AN. Vogler L. Tychsen L. JPOS 33(2):114-9, 1996 Mar-Apr BACKGROUND: Kawasaki disease (KD) is an acute and sometimes fatal febrile vasculitis of childhood, the presenting signs of which include conjunctival vessel dilatation and iridocyclitis. Consultation with a pediatric ophthalmologist is helpful for early recognition of the disease, especially in identifying "incomplete" cases, ie, those which lack all of the classical, systemic signs. METHODS: After encountering a case of incomplete KD in which diagnosis was delayed, we reviewed the hospital records of 37 children with KD to establish how often the disease manifested "incompletely," and how often pediatricians consulted pediatric ophthalmologists to help in its early diagnosis. RESULTS: Forty-five percent of the children eventually diagnosed with KD lacked the complete diagnostic criteria of KD when admitted to the hospital, and diagnosis and treatment therefore were delayed. Coronary artery aneurysms, a complication that might have less serious consequences if treated earlier, developed in 24% of these patients. Although 67% presented to their pediatrician with bilateral conjunctival injection and/or iridocyclitis, pediatricians requested ophthalmologic consultation for only 5% of them. CONCLUSIONS: Our review of these cases indicates that the eye findings in KD could play a role in earlier diagnosis and treatment. Pediatric ophthalmologists and pediatricians should be more aware of their combined responsibilities for expedient recognition of KD.
Pediatrics and StrabismusUnilateral Congenital Ptosis with Ipsilateral Superior Rectus Overaction Steel and Harrad Am J Ophthalmol 1996;122:550-556 Patients with unilateral congenital ptosis can exhibit an upshoot in the affected eye on upgaze - 17/38 patients (44%). This upshoot is not apparent in primary position and is persistent even after ptosis surgery. One patient required a superior rectus posterior fixation suture. The authors also examined patients with non-congenital unilateral and bilateral ptosis. These patients did not exhibit the upshoot phenomenon. The authors discount Herring's Law and suggest nuclear third lesions or redirection syndromes are the root causes for the dysfunction.
Pediatrics and StrabismusDIMENSIONS OF THE PEDIATRIC CRYSTALLINE LENS - IMPLICATIONS FOR INTRAOCULAR LENSES IN CHILDREN Bluestein EC. Wilson E. Wang XH. Rust PF. Apple DJ. Journal of Pediatric Ophthalmology & Strabismus. 33(1):18-20, 1996 As surgeons gain more experience with the implantation of posterior chamber intraocular lenses (IOLs) into the capsular bag in children, the minimum age for which implantation is advised may continue to be lowered. Accurate sizing of an IOL intended for in-the-bag fixation may depend on knowledge of the size of the capsular bag. In order to develop a growth curve for the normal crystalline lens and hence the capsular bag, 50 pediatric autopsy eyes ranging in age from 1 day to 16 years were obtained postmortem and measured within 24 hours after enucleation, Mean crystalline lens diameter was 6.00 mm at birth, 6.80 mm at 2 months, 7.1mm at 3 months, 7.66 mm at 6 to 9 months, 8.4 mm at 21 months, 8.5 mm at 2 to 5 years, and 9.3 mm at 16 years. The post-lensectomy capsular bag size at each respective age is 1 mm larger,While age was a predictor of crystalline lens size, corneal diameter and globe axial length were better predictors of crystalline lens size,These data and accompanying linear regressions may be helpful in designing appropriate IOLs for pediatric patients. [References: 9]
|