Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
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To identify risk factors in children admitted with preseptal or orbital cellulitis with associated intracranial infection. ⋯ Intracranial involvement should be suspected in any patient age > or = 7 years with preseptal or orbital cellulitis associated with orbital subperiosteal abscess, Pott's puffy tumor, concurrent sinusitis, complaints of headache, and continuing fever despite intravenous antibiotics. Given the high incidence of polymicrobial infection found on cultures in this series, broad-spectrum antibiotics are strongly indicated. When imaging the orbits and sinuses in such patients, we recommend including the brain to rule out intracranial involvement.
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Comparative Study
Validity of the Titmus and Randot circles tasks in children with known binocular vision disorders.
The Titmus and Randot (version 2) circles tests contain monocular form cues that may enable patients with binocular vision disorders to pass without any measurable stereopsis. The purpose of this study was to evaluate the validity of the Randot and Titmus circles tests for quantifying stereoacuity in children with known binocular vision disorders. ⋯ When measuring stereoacuity using either the Titmus or Randot circles tests in patients with known binocular vision disorders, stereoacuity scores > 2.2 log seconds of arc should be interpreted with caution because it is above this level of stereoacuity that the monocular form cues of each of the tests may invalidate the results.
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Comparative Study
Adult strabismus surgery under propofol sedation with local versus general anesthesia.
To compare operating room and hospital discharge times between adult strabismus surgeries using intravenous propofol sedation with local anesthesia versus those using general anesthesia. ⋯ Many adult strabismus surgeries may be performed more efficiently with intravenous propofol sedation and local subtenon's anesthesia than with general anesthesia. Times from the end of surgery to leaving both the OR and the hospital are decreased compared with those of general anesthesia. Extreme delays are rare with propofol/local, but they occurred with general anesthesia.
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Randomized Controlled Trial Clinical Trial
Subtenons lidocaine injection for postoperative pain relief after strabismus surgery in children: a pilot study.
Ophthalmologists are now encouraged to perform strabismus surgery as an outpatient procedure, but postoperative pain may be a barrier to discharge. Systemic analgesics have side effects or are contraindicated in some patients. We designed a trial to determine the efficacy of subtenons lidocaine injection at reducing postoperative pain and systemic analgesia requirements. ⋯ These data provide some evidence of an association between the use of subtenons lidocaine injection and a reduction of pain experienced by children in the immediate postoperative period following primary strabismus surgery.