Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
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Herpes zoster ophthalmicus, although not uncommon in adults, is rarely found in children. Herein we present a case of pediatric herpes zoster ophthalmicus that is unique in 2 ways. ⋯ Second, the initial presentation of herpes zoster ophthalmicus was a painful and diffuse subconjunctival hemorrhage that appeared before any of its classic signs were observed. We report this case to document the possible occurrence of herpes zoster ophthalmicus in children who have been vaccinated against varicella and the possibility of a diffuse, painful subconjunctival hemorrhage as a presenting sign.
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High refractive errors and optical aberrations reduce vision when the lens edge bisects the pupil. We studied outcomes of eyes with ectopia lentis following lensectomy. ⋯ Our cohort of patients with long-term follow-up shows that pars plana lensectomy can be successful in restoring vision when conservative measures fail.
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Comparative Study
Comparison of visual acuity levels in pediatric patients with amblyopia using Wright figures, Allen optotypes, and Snellen letters.
To compare and correlate the clinical performance of Wright figures in visual acuity assessments of pediatric patients with amblyopia to those obtained through Allen cards and Snellen letters. ⋯ Wright figures, designed primarily to evaluate the vision in the preliterate pediatric population, correlate more closely to Snellen letters and have a higher rate of correctly identifying amblyopia than isolated Allen optotypes in pediatric patients.
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To establish child abuse as part of the differential diagnosis of isolated bilateral subconjunctival hemorrhages in infants. ⋯ Nonaccidental trauma should be considered in the differential diagnosis of bilateral isolated subconjunctival hemorrhages in infants especially if associated with facial petechiae. These isolated subconjunctival hemorrhages may be part of the traumatic asphyxia syndrome caused by severe, prolonged compression of the child's chest and upper abdomen. Appropriate assessment includes a complete ophthalmic and pediatric examination as well as hematological testing and imaging studies. If the coagulation profile and initial imaging studies are normal yet there remains a high suspicion of abuse, an immediate nuclear scan or a repeat skeletal survey or chest film 2 weeks later is indicated.