Journal of Pediatric Ophthalmology & Strabismus最新文献

{"title":"Performance of Automated Vision Screening and Refraction in Young Children in Belize.","authors":"Hannah Istre-Wilz, Eliza Barnwell, Emily J Scircle, Rupal Trivedi, Bethany Wolf, Joanna Mendez-Silva, Mae Millicent Peterseim","doi":"10.3928/01913913-20260901-03","DOIUrl":"https://doi.org/10.3928/01913913-20260901-03","url":null,"abstract":"<p><strong>Purpose: </strong>To determine how automated instrument-based screening with the Spot Vision Screener (SVS) (Welch Allyn, Inc/Baxter) compares with standard visual acuity testing in Belizean schoolchildren, and to compare refractive results of the SVS and QuickSee hand-held autorefractor (PlenOptika).</p><p><strong>Methods: </strong>During a school-based vision screening program in Orange Walk, Belize, SVS performance was evaluated against visual acuity testing as the reference standard. Children failing visual acuity per American Association for Pediatric Ophthalmology and Strabismus (AAPOS)/National Center for Children's Vision and Eye Health guidelines (20/30 for age 5 years and older, 20/40 for age 4 years, and 20/50 for age 3 years) were considered referrals. SVS performance was assessed under three referral criteria sets: manufacturer thresholds, AAPOS 2021 guidelines, and stricter exploratory thresholds. Agreement between the SVS and QuickSee hand-held autorefractor was analyzed using intraclass correlation coefficients and mean bias.</p><p><strong>Results: </strong>Of 1,009 children screened, 692 had both visual acuity and SVS measurements; 11.6% failed visual acuity screening. SVS sensitivity and specificity varied by criteria: manufacturer (45.0%, 95.3%), AAPOS (31.25%, 97.7%), and stricter thresholds (61.24%, 82.0%). Positive predictive value ranged from 30.82% to 64.10%. Stricter criteria increased sensitivity but reduced specificity. Device agreement analysis (589 children) showed moderate correlation for cylinder (intraclass correlation coefficient = 0.724) and sphere (intraclass correlation coefficient = 0.557), with the SVS tending to report higher refractive magnitudes.</p><p><strong>Conclusions: </strong>Automated screening using the SVS is a good option in school settings and can complement visual acuity testing, particularly where resources are limited. Referral thresholds should be tailored to program priorities to balance sensitivity and specificity. Agreement between the SVS and QuickSee supports their utility for efficient refractive assessment in community-based programs.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149196715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medial Rectus Inferior Plication in the Management of Near Exodeviations.","authors":"Haider Shah, Zakharia Ali, Ian Marsh","doi":"10.3928/01913913-20260810-01","DOIUrl":"https://doi.org/10.3928/01913913-20260810-01","url":null,"abstract":"<p><strong>Purpose: </strong>To assess outcomes of medial rectus inferior half plication (MR-iP) surgery for the management of near exodeviations, and to define optimal patient selection and surgical dosing for this procedure.</p><p><strong>Methods: </strong>A retrospective analysis of 39 consecutive MR-iP procedures for near exodeviation, performed by a single surgeon, was conducted. Preoperative and postoperative orthoptic measurements, outcomes, and dose-response relationships were evaluated.</p><p><strong>Results: </strong>Thirty-seven patients underwent 39 MR-iP procedures. The mean age was 47 years (range: 12 to 80 years). Of 39 procedures, 56% were unilateral and 44% were bilateral. Preoperatively, mean distance deviation was 5.7 prism diopters (PD), near deviation was 17.7 PD, and near-distance disparity was 12 PD. Postoperatively, mean distance deviation was 4.5 PD, near deviation was 9.8 PD, and disparity was 5.3 PD, representing a 34% reduction in near angle and 56% reduction in disparity (<i>P</i> < .001). Distance alignment remained unchanged (<i>P</i> = .08). Overall, 70% achieved surgical success, rising to 90.5% when preoperative near deviation was 20 PD or less, but falling to 44.4% when greater than 20 PD. Complications were rare; one patient developed a self-limiting hematoma due to dysplastic cytopenia. No sustained overcorrections occurred. Mean surgical effect was approximately 2 PD/mm plicated.</p><p><strong>Conclusions: </strong>MR-iP is a well-tolerated, targeted approach for symptomatic near exodeviations, achieving statistically significant reductions in near angle and disparity while maintaining distance alignment. A practical titration dose of 2 PD/mm is recommended. This procedure expands the surgical options for convergence insufficiency exotropia, with low rates of overcorrection.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural Evaluation of Retinal and Choroidal Features in Eyes With Primary Microtropia.","authors":"Havvanur Bayraktar, Cansu Ekinci Aslanoğlu, Betül Tuğcu","doi":"10.3928/01913913-20260806-01","DOIUrl":"https://doi.org/10.3928/01913913-20260806-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the structural characteristics of the macula, optic nerve head, and choroid in eyes with primary microtropia using spectral-domain optical coherence tomography (SD-OCT).</p><p><strong>Methods: </strong>This prospective case-control study included 50 pediatric patients with a diagnosis of primary microtropia. Each participant contributed data from both eyes. Eyes were categorized as microtropic, fellow, or healthy control. All patients underwent comprehensive ophthalmic evaluation, including SD-OCT imaging. Parameters assessed included central macular thickness, total macular volume, regional retinal thickness, peripapillary retinal nerve fiber layer thickness, subfoveal and regional choroidal thickness, and choroidal vascular index.</p><p><strong>Results: </strong>No statistically significant differences were observed among microtropic, fellow, and control eyes in terms of central macular thickness, total macular volume, or peripapillary retinal nerve fiber layer thickness (<i>P</i> > .05). Although microtropic eyes showed a mild trend toward increased parafoveal and perifoveal retinal thickness across all quadrants, this variation did not reach statistical significance. Similarly, subfoveal, nasal, and temporal choroidal thickness measurements, as well as choroidal vascularity index, luminal area, stromal area, and total choroidal area, were comparable across all groups.</p><p><strong>Conclusions: </strong>Primary microtropia was not associated with measurable retinal or choroidal structural abnormalities on SD-OCT. Although reduced visual acuity was present, the lack of detectable anatomical changes warrants further investigation to determine whether functional impairment in microtropia occurs independently of structural alterations.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Nasolacrimal Duct Obstruction Care Between Demographic Groups.","authors":"Catherine Sano, Shaleen Arora, Monica Manrique, Sinan Akosman, Kendall Sano, Robert Thomasian, Aya Bourdi, Md Sohel Rana, Marlet Bazemore, Jonathan Taylormoore, Richard Birdsong, William P Madigan","doi":"10.3928/01913913-20260901-02","DOIUrl":"https://doi.org/10.3928/01913913-20260901-02","url":null,"abstract":"<p><strong>Purpose: </strong>To compare nasolacrimal duct obstruction (NLDO) pediatric ophthalmic care between different demographic groups in Washington, DC.</p><p><strong>Methods: </strong>A retrospective review of pediatric patients with NLDO who received care at one tertiary care institution from 2012 to 2022 was performed. Age, sex, race and ethnicity, insurance type, language interpreter use, and consultation information were analyzed. Surgical intervention, follow-up information, and reoperation rates were also collected.</p><p><strong>Results: </strong>A total of 1,338 patients (median age: 1.3 years) were analyzed. Hispanic, Black/African American, and unreported racial and ethnic minority patients were older at the time of initial consultation when compared to White patients. Statistically significant delays in surgical intervention following the initial visit were seen among non-English-speaking and Medicaid insured patients (<i>P</i> = .001 and .017, respectively).</p><p><strong>Conclusions: </strong>Factors such as race and ethnicity, language, and Medicaid coverage are intersecting elements that may contribute to disparities in care, manifesting particularly in specialized medical care. There are systemic barriers to pediatric ophthalmic care that may disproportionately impact vulnerable populations. Although there were no clinically significant differences in outcome, it is appropriate to understand these disparities can be present in the clinical setting to avoid a negative impact on children from racial and ethnic minority groups. Future studies discerning actionable causes of health disparity are necessary to navigate toward equitable care.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Visual Acuity and Binocular Fusion in Refractive Amblyopia.","authors":"Duanzhi Ma, Zhou Zhou, Li Ren, Lei Zhang","doi":"10.3928/01913913-20251107-01","DOIUrl":"10.3928/01913913-20251107-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate alterations in perceptual fusion and motor fusion in children with refractive amblyopia before and after treatment, and analyze the relationship between fusion function and changes in best corrected visual acuity (BCVA).</p><p><strong>Methods: </strong>A study was undertaken of children with amblyopia aged 4 to 12 years who were treated at the outpatient department of Binzhou Medical College Affiliated Hospital from July 2024 to July 2025. The study comprised 38 children (38 eyes) with anisometropic amblyopia, 30 (30 eyes) with ametropic amblyopia, and 30 (30 eyes) with normal vision. All children with amblyopia underwent cycloplegic refraction, fusion function measurement, and comprehensive amblyopia treatment.</p><p><strong>Results: </strong>BCVA, perceptual fusion, positive fusion, and fusion range were significantly lower in children with refractive amblyopia compared to those with normal vision (<i>P</i> < .001). Following 3 months of comprehensive amblyopia treatment, BCVA, positive fusion, and fusion range in children with amblyopia improved compared to pretreatment levels (<i>P</i> < .001). The enhancement of perceptual fusion function in anisometropic amblyopia after treatment (<i>P</i> = .001) was superior to that in ametropic amblyopia (<i>P</i> = .125). A moderate positive correlation was observed between BCVA improvement and the enhancement of positive fusion function and fusion range (<i>r</i> = 0.469, <i>P</i> = .003; <i>r</i> = 0.440, <i>P</i> = .006, respectively). Additionally, there was a weak positive correlation between the improvement in positive fusion function and BCVA (<i>r</i> = 0.382, <i>P</i> < .05).</p><p><strong>Conclusions: </strong>Following treatment, positive fusion and fusion range improved significantly in refractive amblyopia. Perceptual fusion function was markedly enhanced in anisometropic amblyopia following treatment.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"328-334"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact Lens-Based Management of Neurotrophic Keratopathy in Rhombencephalosynapsis Without Alopecia (a Gómez-López-Hernández Syndrome Variant).","authors":"Andreas J M van Henten, Isabelle E Y Saelens, Catherine Cassiman","doi":"10.3928/01913913-20260529-02","DOIUrl":"10.3928/01913913-20260529-02","url":null,"abstract":"<p><p>A child with rhombencephalosynapsis, part of the Gómez-López-Hernández spectrum, developed bilateral corneal hypoesthesia and neurotrophic keratopathy. Recurrent epithelial defects and progressive corneal haze occurred despite conservative therapy with lubrication, serum drops, and topical treatment. A persistent epithelial defect healed rapidly after application of a bandage contact lens. This case highlights the importance of early ophthalmologic surveillance and corneal sensitivity assessment in children with rhombencephalosynapsis. Bandage contact lenses are a safe and effective treatment option in pediatric neurotrophic keratopathy, promoting epithelial healing and helping prevent corneal scarring and vision loss.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"63 5","pages":"e39-e42"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Stereoacuity and Fusional Vergence Amplitudes in Children With Autism Spectrum Disorder: A Comparative Study.","authors":"Zeynep Akgun, Furkan Ozkan, Oyku Akkas, Sezen Kose, Elif Demirkilinc Biler","doi":"10.3928/01913913-20251204-04","DOIUrl":"10.3928/01913913-20251204-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the binocular vision and fusion potentials in children diagnosed as having autism spectrum disorder (ASD), while also assessing visual acuity, refractive errors, and the prevalence of strabismus, in comparison with typically developing peers.</p><p><strong>Methods: </strong>This study included 57 children diagnosed as having ASD and 45 age-matched typically developing children as controls (control group). Comprehensive ophthalmologic examinations were performed in both groups, including best corrected visual acuity (BCVA), biomicroscopic evaluation of anterior and posterior segments, presence of strabismus, measurement of stereoacuity, fusional vergence amplitudes, near point of convergence, and refractive errors. Data and findings were comparatively evaluated between the two groups.</p><p><strong>Results: </strong>The mean age was 12.10 ± 3.29 years (range: 7 to 18 years) in the ASD group and 10.91 ± 3.08 years (range: 7 to 18 years) in the control group, with no statistically significant difference between the groups (<i>P</i> = .080). A significantly higher prevalence of female participants was observed in the ASD group (<i>P</i> = .003). There was no significant difference in BCVA between the groups (<i>P</i> = .398). Strabismus was detected in 24.56% of the ASD group and 13.33% of the control group. Stereopsis of 480 sec/arc seconds and worse was observed in 47 (82.46%) patients in the ASD group and 4 (8.89%) patients in the control group, with a statistically significant reduction in stereopsis in the ASD group (<i>P</i> = .035). Emmetropia was present in 63.15% of the patients in the ASD group and 40% of the control group, whereas myopia was the most prevalent refractive error for both groups. Fusional amplitudes for convergence and divergence at near distance were found to be lower in the ASD group; however, no statistically significant differences were observed at distance fixation or in near point of convergence measurements.</p><p><strong>Conclusions: </strong>In children with ASD, stereoacuity and near fusion amplitudes were reduced and the near point of convergence increased. These findings are likely associated with cognitive impairments and attentional deficits characteristic of ASD, potentially rendering near vision tasks particularly challenging. Recognizing and addressing these visual function impairments may facilitate both visual and cognitive development in this patient population.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"355-360"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Keratoplasty: Indications, Techniques, and Long-term Outcomes.","authors":"Mustafa Yıldırım, Ayșenur Sönmez, Kamber Kașali","doi":"10.3928/01913913-20260105-03","DOIUrl":"10.3928/01913913-20260105-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the indications and long-term clinical outcomes of patients aged 18 years and younger who underwent keratoplasty surgery.</p><p><strong>Methods: </strong>In this study, the medical records of 55 eyes from 43 patients younger than 18 years who underwent keratoplasty and were registered in the Atatürk University Faculty of Medicine Research Hospital between March 2014 and May 2024 were retrospectively reviewed. Pre-operative evaluations included corrected distance visual acuity (CDVA) and anterior and posterior segment examinations. Postoperative complications, CDVA, and graft survival status were assessed. Only patients with a minimum follow-up period of 1 year were included in the study.</p><p><strong>Results: </strong>The mean age of the patients was 14.1 years (range: 6 to 17 years), and the mean follow-up duration was 45 months (range: 12 to 124 months). Although 47 of the patients had penetrating keratoplasty (PKP), 8 had deep anterior lamellar keratoplasty (DALK). The most common indication was advanced keratoconus (60%). There was a statistically significant difference between preoperative and 1-year postoperative CDVA (<i>P</i> < .001). Improvement in visual acuity was observed in 81.81% of patients. The overall graft survival rate was 92.73%.</p><p><strong>Conclusions: </strong>This study shows that keratoconus is the most common indication for keratoplasty in pediatric cases. The study demonstrates a high rate of improvement in graft survival and visual acuity in pediatric cases.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"368-372"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Choroidal Melanocytosis in a Young Girl.","authors":"Riley J Lyons, G Baker Hubbard, Jill R Wells","doi":"10.3928/01913913-20260421-01","DOIUrl":"10.3928/01913913-20260421-01","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"380"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal Corneal Clouding as the Initial Manifestation of Biotinidase Deficiency.","authors":"Emine Tınkır Kayıtmazbatır, Saime Sündüs Uygun, Ebru Marzioğlu Özdemir, Banu Kadıoğlu Yılmaz, Murat Konak, Banu Bozkurt","doi":"10.3928/01913913-20260624-01","DOIUrl":"10.3928/01913913-20260624-01","url":null,"abstract":"<p><p>Biotinidase deficiency is a treatable metabolic disorder associated with neurological and ophthalmic manifestations. The authors describe a newborn presenting with corneal clouding at birth. To the best of the authors' knowledge, only one similar case has previously been reported in the literature. Biotinidase activity was markedly reduced, and genetic testing confirmed a pathogenic biotinidase deficiency variant. Corneal opacity resolved completely after biotin therapy, indicating a rare but reversible ocular manifestation. Biotinidase deficiency should be considered in the differential diagnosis of neonatal corneal clouding. Early recognition is critical because prompt biotin therapy may lead to complete reversal of ocular findings and prevent irreversible neurological complications.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"63 5","pages":"e48-e50"},"PeriodicalIF":1.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}