Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus
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Ophthalmia neonatorum is defined as conjunctivitis appearing during the first month of life. The differential diagnosis includes chemical, bacterial, viral, and other pathogens, including Neisseria gonorrhoeae, herpes simplex, and Chlamydia trachomatis. Neisseria meningitidis is not commonly specifically included in the differential.
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The finding of retinal or vitreous hemorrhage in a child under age 3 years may cause significant controversy with regard to the etiology, because it raises the suspicion of nonaccidental injury. Blood dyscrasias have been documented to cause retinal and vitreous hemorrhages in adults and children, but they have rarely been reported to be the cause of retinal hemorrhages in neonates. We report on a patient with a low plasma fibrinogen level who had bilateral retinal hemorrhage that proceeded to vitreous hemorrhage. This subtle abnormality of the blood clotting cascade caused significant retinal and vitreous hemorrhage in a child without risk factors for abuse.
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Comparative Study
Instrument-induced measurement errors during strabismus surgery.
The purpose of this study was to determine the clinical setting where errors in measurements of muscle position during strabismus surgery made by the Scott curved ruler or by calipers become important and to characterize the magnitude of those errors. ⋯ Both the Scott curved ruler and calipers are accurate in measuring arc lengths 9.0 mm or less. For longer arc length measurements, accuracy becomes dependent on axial length. The Scott curved ruler, although substantially more accurate than calipers for most common axial lengths, can introduce clinically important measurement errors when measuring arc lengths as small as 12 mm. Axial length should be considered when measuring muscle position during strabismus surgery.
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The cause of eyelid pruritus (itching) may be difficult to determine, particularly in preverbal children. Tearing, photophobia, or eye rubbing may be the first manifestation of leukemic infiltration or graft-versus-host disease, necessitating early appropriate therapy. We report a child in whom persistent eye rubbing developed after bone marrow transplantation for leukemia. Morphine administration was found to be the cause of this symptom.
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Randomized Controlled Trial Comparative Study Clinical Trial
Levodopa-carbidopa and childhood retinal disease.
Our purpose was to determine the influence of levodopa-carbidopa on visual function in children with retinal disease. ⋯ The results are consistent with the hypothesis that dopamine influences the receptive field characteristics of retinal cells. The results also suggest that there may be low retinal dopamine levels in some types of retinal disease, which may be amenable to treatment.