Journal of pediatric ophthalmology and strabismus
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J Pediatr Ophthalmol Strabismus · May 1995
Case ReportsInterstitial keratitis as presenting ophthalmic sign of sarcoidosis in a child.
Interstitial keratitis is a rarely occurring sign in sarcoidosis. We report a case of childhood sarcoidosis with initial ocular presentation as interstitial keratitis. Erythema nodosum preceded the ocular findings by 4 years and arthritis developed 1 year after ocular findings developed. ⋯ Systemic steroids were used to treat the patient's skin lesions and topical steroids to treat his corneal inflammation. He developed posterior uveitis and optic nerve edema both of which were responsive to oral steroids. Two years after the presentation of his ocular findings, the onset of pulmonary symptoms and resultant transbronchial biopsy confirmed his diagnosis of sarcoidosis.
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J Pediatr Ophthalmol Strabismus · Nov 1993
Magnetic resonance imaging of the visual pathways in human albinos.
Neuroanatomical and electrophysiological studies of albino visual pathways have demonstrated that retinogeniculate axons arising from the temporal retina decussate abnormally in the optic chiasm to synapse in the contralateral lateral geniculate nucleus (LGN). Anomalies in the LGN secondarily disrupt normal geniculo-cortical and interhemispheric cortico-cortical (callosal) visual connections. ⋯ In all subjects, these structures were normal in size and configuration. Despite the complex cascade of aberrant central neuronal connections, the human albino visual pathways and their interhemispheric connections appear normal in size and configuration when viewed with MRI.
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J Pediatr Ophthalmol Strabismus · Sep 1993
The intraoperative oculocardiac reflex as a predictor of postoperative vaso-vagal responses during adjustable suture surgery.
Adjustable suture surgery has become a popular method of strabismus correction in those cases in which results are less predictable, such as reoperations, thyroid ophthalmopathy, and blind eyes. Complications related to adjustable strabismus surgery are, in general, no different than those related to standard surgical techniques. We noticed a subgroup of patients who experienced significant vaso-vagal responses (V-VR) during postoperative adjustment and sought to discover a method of identifying these patients prior to adjustment. ⋯ Eighty-five percent of patients with a positive OCR and 9% of patients with a negative OCR had a positive V-VR. Younger patients were also more likely to have a positive V-VR. A positive intraoperative OCR under general anesthesia during strabismus surgery is highly predictive of a postoperative V-VR during planned adjustment.
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J Pediatr Ophthalmol Strabismus · Mar 1993
Etiology of eyelid retraction in children: a retrospective study.
Eyelid retraction in an adult occurs usually secondary to Graves' ophthalmopathy, but in children the diagnosis is often obscure. To our knowledge, there are no reports reviewing the relative frequency of the various etiologies of eyelid retraction in children. We reviewed the records of our Pediatric Service from 1976 to 1991 and identified 16 children with eyelid retraction. ⋯ Seven of our 11 patients with unilateral retraction had an identifiable etiology, and the remaining four patients had incomplete evaluations. Imaging studies were diagnostic in four of nine patients so studied. Based on our findings, we recommend thyroid studies in all patients with eyelid retraction without aberrant innervation, and neuroimaging if thyroid function is normal.