Journal of AaposPub Date : 2025-10-18DOI: 10.1016/j.jaapos.2025.104675
Monisha Mohan, Sajeev Cherian Jacob
{"title":"Progression of acute comitant esotropia into cyclical esotropia in a 7-year-old child.","authors":"Monisha Mohan, Sajeev Cherian Jacob","doi":"10.1016/j.jaapos.2025.104675","DOIUrl":"https://doi.org/10.1016/j.jaapos.2025.104675","url":null,"abstract":"<p><p>We report the case of a 7-year-old girl who, following prolonged screen exposure, developed acute comitant esotropia, which progressed within 1 month to a cyclical pattern. For 4 months the cycles followed a 48-hour pattern, afterward progressing to episodes of esotropia lasting interspersed with a day of orthophoria, for another 2 months. Subsequently, the patient developed suppression and constant esotropia. Once the strabismus angles stabilized and remained reproducible, she underwent a 5.5 mm bilateral medial rectus recession. Postoperatively, she achieved orthophoria with restored binocularity and full stereopsis for both distance and near. Acute comitant esotropia is a well-documented condition associated with excessive screen time and near activities, typically presenting with diplopia beyond infancy. Cyclical esotropia, a rare form of strabismus, follows a pattern of alternating esotropia and orthophoria, with cycles ranging from 48 hours to several days.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104675"},"PeriodicalIF":1.3,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338096","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}
Journal of AaposPub Date : 2025-10-14DOI: 10.1016/j.jaapos.2025.104660
Nir Zontag, Jacob Perkins, Brittany M Wong, Alex V Levin
{"title":"Incidence and characterization of retinal findings after SARS-CoV-2 infection in children.","authors":"Nir Zontag, Jacob Perkins, Brittany M Wong, Alex V Levin","doi":"10.1016/j.jaapos.2025.104660","DOIUrl":"https://doi.org/10.1016/j.jaapos.2025.104660","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether SARS-CoV-2 infection is associated with retinal hemorrhage in young children.</p><p><strong>Methods: </strong>The medical records of children <8 years of age treated in the University of Rochester healthcare system between July 1, 2020, and July 1, 2024, who underwent ophthalmologic examination, within 28 days of a COVID-19 diagnosis were reviewed retrospectively.</p><p><strong>Results: </strong>A total of 8,196 children were diagnosed with COVID-19 during the study period. Of these, 56 had a dilated ocular examination within 28 days of their COVID-19 diagnosis. All fundus examinations were normal except for 1 patient with optic nerve edema. Our findings suggest with 95% confidence, that the true incidence of retinal hemorrhage in children <8 years old following COVID-19 infection is likely to be <9.09% at 14 days, 7.69% at 21 days, and 5.35% at 28 days.</p><p><strong>Conclusions: </strong>Our data, along with a review of the literature, suggest that there is little if any evidence that SARS-CoV-2 infection causes retinal hemorrhage in young children.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104660"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309796","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}
Journal of AaposPub Date : 2025-10-07DOI: 10.1016/j.jaapos.2025.104659
Jeffrey Kuziel, Margaret Strampe, Joel VandeLune, Christian Zirbes, Scott Larson, Alina Dumitrescu
{"title":"Factors influencing the timing of complete retinal vascularization in infants screened for retinopathy of prematurity.","authors":"Jeffrey Kuziel, Margaret Strampe, Joel VandeLune, Christian Zirbes, Scott Larson, Alina Dumitrescu","doi":"10.1016/j.jaapos.2025.104659","DOIUrl":"https://doi.org/10.1016/j.jaapos.2025.104659","url":null,"abstract":"<p><strong>Background: </strong>Premature infants screened for retinopathy of prematurity (ROP) reach complete retinal vascularization at various postmenstrual ages (PMAs). The purpose of this study was to evaluate the factors that affect the age at which the infant eyes reach retinal vascular maturity.</p><p><strong>Methods: </strong>We reviewed patients screened for ROP at our institution between December 13, 2007, and December 30, 2020. Data extracted included demographics, gestational age (GA) and birth weight (BW), ROP examinations, age and weight at retinal maturity, surgical procedures, ventilation status, antibiotic treatment, positive blood cultures, blood transfusions, and central line placement.</p><p><strong>Results: </strong>A total of 1,971 patients were analyzed. The mean GA at birth was 28 weeks, and the mean BW was 1,096 g. Mean PMA for retinal maturity was 44.90 weeks. Mean PMA at retinal maturity was higher for infants born at an earlier GA (P < 0.0001). Additionally, infants who underwent nonocular surgery reached retinal maturity at significantly high PMA (P < 0.0001). Infants with stage 1 ROP or greater had a significantly longer time from birth to retinal maturity (P < 0.0001) and those with stage 2 or 3 disease reached retinal maturity at even older chronological ages (P < 0.0001). Chronological age at retinal maturity was also higher for children with positive blood cultures or who received transfusions ≥5 units (P < 0.0001).</p><p><strong>Conclusions: </strong>Postmenstrual age at retinal maturity and chronological age at retinal maturity both vary widely among infants at risk of ROP, and are associated with a variety of ocular and systemic clinical predictors.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104659"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259820","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":"Sudden bilateral vision loss in a child with LYRM7-related leukoencephalopathy.","authors":"Lubhavni Dewan, Vyshnavika Mupparapu, Ramesh Kekunnaya, Goura Chattannavar","doi":"10.1016/j.jaapos.2025.104658","DOIUrl":"10.1016/j.jaapos.2025.104658","url":null,"abstract":"<p><p>A 4-year-old boy presented with poor vision following an episode of febrile illness with abdominal distension, seizures, and respiratory distress with metabolic acidosis. He had bilateral partial optic atrophy. Neuroimaging revealed bilateral symmetric post-contrast enhancement of the optic nerves, diffuse white matter T2-hyperintensities, and a lactate peak on magnetic resonance spectroscopy. Serology for aquaporin-4 and myelin-oligodendrocyte antibodies were negative. Whole exome sequencing showed a homozygous pathogenic variant in the LYRM7 gene (c.2T>C) known to cause mitochondrial complex III deficiency. Following initiation of mitochondrial cocktail therapy, his visual behavior improved.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104658"},"PeriodicalIF":1.3,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228326","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}
Journal of AaposPub Date : 2025-09-30DOI: 10.1016/j.jaapos.2025.104656
J Daniel Twelker, Andrew W Arthur, Rita Bhakta, Amy L Davis, Leslie K Dennis, Siomara G Enriquez, Kimberly D Gerhart, Chiu-Hsieh Hsu, M Sandra González Marshall, Jenifer Martin, Eileen R McGrath, Joseph M Miller, Divya Ramesh, Erin M Harvey
{"title":"Agreement between the Spot Vision Screener and cycloplegic retinoscopy for toddlers with astigmatism.","authors":"J Daniel Twelker, Andrew W Arthur, Rita Bhakta, Amy L Davis, Leslie K Dennis, Siomara G Enriquez, Kimberly D Gerhart, Chiu-Hsieh Hsu, M Sandra González Marshall, Jenifer Martin, Eileen R McGrath, Joseph M Miller, Divya Ramesh, Erin M Harvey","doi":"10.1016/j.jaapos.2025.104656","DOIUrl":"10.1016/j.jaapos.2025.104656","url":null,"abstract":"<p><strong>Background: </strong>We investigated the agreement between the Spot Vision Screener (Welch Allyn) and gold standard cycloplegic retinoscopy in infants and toddlers, with special attention to astigmatism.</p><p><strong>Methods: </strong>Participants were children 12-35 months of age who failed a routine photoscreening using the Spot conducted at a recent well-child visit and who subsequently received a cycloplegic eye examination through the Spectacle Prescribing in Early Childhood Study (SPECS).</p><p><strong>Results: </strong>The final sample included 410 children, with an average age of 20.24 months. The Spot mean spherical equivalent value (M) was significantly less hyperopic than cycloplegic retinoscopy M (+0.35 D vs +0.80 D, t[409] < 0.001), and mean Spot Vision Screener cylinder (CYL) was significantly higher than cycloplegic retinoscopy CYL (1.84 D. vs 1.58 D, t[409] < 0.001).</p><p><strong>Conclusions: </strong>Cycloplegic retinoscopy found more hyperopic, or conversely, less myopic sphere power, in 60% of participants at the clinically significant level of >0.50 D. When using the Spot, this could result in under-referral to an eye care professional for moderate to high hyperopia. About 1 in 4 subjects showed higher clinically significant cylinder (>1.00 D) using the Spot compared with cycloplegic retinoscopy, which could result in over-referral for astigmatism when using the 2013 criteria for astigmatism.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104656"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214324","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}
Journal of AaposPub Date : 2025-09-29DOI: 10.1016/j.jaapos.2025.104655
Alexander C Lieu, Evan H Walker, Shira L Robbins, David B Granet, Jolene C Rudell
{"title":"Socioeconomic trends of adult strabismus in the United States: an analysis of the All of Us database.","authors":"Alexander C Lieu, Evan H Walker, Shira L Robbins, David B Granet, Jolene C Rudell","doi":"10.1016/j.jaapos.2025.104655","DOIUrl":"10.1016/j.jaapos.2025.104655","url":null,"abstract":"<p><strong>Purpose: </strong>To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.</p><p><strong>Methods: </strong>Annual income, highest level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ<sup>2</sup> test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.</p><p><strong>Results: </strong>Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.</p><p><strong>Conclusions: </strong>Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104655"},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208123","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}
Journal of AaposPub Date : 2025-09-29DOI: 10.1016/j.jaapos.2025.104657
Alexander C Lieu, Evan H Walker, Shira L Robbins, David B Granet, Jolene C Rudell
{"title":"Epidemiology of strabismus among adults in the United States: insights from the All of Us database.","authors":"Alexander C Lieu, Evan H Walker, Shira L Robbins, David B Granet, Jolene C Rudell","doi":"10.1016/j.jaapos.2025.104657","DOIUrl":"10.1016/j.jaapos.2025.104657","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the prevalence of adult-diagnosed strabismus and its associations with sex, age, and race in a large, diverse population database in the United States.</p><p><strong>Methods: </strong>Sex, age, and race data were collected from 413,457 individuals in the All of Us database. The χ<sup>2</sup> test with post hoc pairwise comparisons was used to determine significant differences in distributions of sex, age, and race data in 3,734 strabismus patients compared with the overall database.</p><p><strong>Results: </strong>There is a higher proportion of males among patients with strabismus compared with the overall database (43.34% vs 38.34% [P < 0.001]). There is a significantly higher proportion of patients aged over 65 years among patients with strabismus compared with the overall database (45.77% vs 24.7% [P < 0.001]). There is also a significantly different racial distribution of individuals with strabismus compared with the overall database (P < 0.001). Pairwise comparisons showed a significantly lower proportion of Asian individuals among patients with strabismus or heterotropia, a lower proportion of Black individuals with most subtypes, and a higher proportion of White individuals among patients with any strabismus.</p><p><strong>Conclusions: </strong>These results suggest that there is a lower proportion of females, Asian, and Black participants with diagnosed strabismus compared with the overall population in the All of Us database. These findings may indicate that strabismus affects patient populations differently, or that there is differential access to care and diagnosis of strabismus across sex, age, and race.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104657"},"PeriodicalIF":1.3,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208205","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}
Journal of AaposPub Date : 2025-09-26DOI: 10.1016/j.jaapos.2025.104654
Jenny Chun Ling Kuo, Xinxing Guo, Megan E Collins
{"title":"Phased multimodal consent in a Baltimore school-based vision program: a novel approach.","authors":"Jenny Chun Ling Kuo, Xinxing Guo, Megan E Collins","doi":"10.1016/j.jaapos.2025.104654","DOIUrl":"10.1016/j.jaapos.2025.104654","url":null,"abstract":"<p><p>Obtaining parental consent is a crucial step for students to receive eye examinations in school-based vision programs (SBVPs). Using paper consent forms is challenging and may limit responses. We explored a novel, phased, multimodal consent approach in a Baltimore SBVP to increase program participation during the 2022-23 school year. Vision screenings were provided for all students as part of the program. Consent outreach was conducted for all students prior to vision screening (universal phase) and again after for students who failed a vision screening (targeted phase). Email consent only was used during the universal phase, whereas a tiered approach that combined email, paper, and telephone was used in the targeted phase. Of the 46 schools that implemented multimodal consenting, the mean overall consent response rate was 86% ± 9.3% (range, 62%-99%). Mean universal and targeted consent response rate was 15% (95% CI, 13%-18%) and 71% (95% CI, 68%-74%), respectively. Among targeted consent responses, 10% were obtained by email, 26% by paper, and 64% by telephone.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104654"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187261","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}
Journal of AaposPub Date : 2025-09-26DOI: 10.1016/j.jaapos.2025.104653
Veronika Yehezkeli, Stacy L Pineles, Federico G Velez
{"title":"Fibrotic bands in thyroid eye disease: a contributing factor to persistent postoperative restriction.","authors":"Veronika Yehezkeli, Stacy L Pineles, Federico G Velez","doi":"10.1016/j.jaapos.2025.104653","DOIUrl":"10.1016/j.jaapos.2025.104653","url":null,"abstract":"<p><p>Accessory extraocular fibrous bands are orbital structures that are typically symptomatic in patients with congenital cranial dysinnervation disorders. However, orbital imaging studies have documented asymptomatic accessory extraocular fibrous in individuals without strabismus. The role of preexisting symptomatic fibrotic bands in causing persistent restrictive strabismus in patients with acquired strabismus and the possibility that inflammatory conditions affecting the extraocular muscles could also affect those bands is rarely discussed. We present 2 cases of thyroid eye disease (TED) in which asymptomatic bands likely became clinically significant with progression of TED. Both patients developed restrictive strabismus and underwent strabismus surgery. Both showed persistent positive forced duction tests (FDT) despite muscle disinsertion. Intraoperative identification and excision of fibrotic bands led to normalization of the FDT and improved surgical outcomes. These bands may contribute to atypical motility patterns in TED.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104653"},"PeriodicalIF":1.3,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187239","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}
Journal of AaposPub Date : 2025-09-21DOI: 10.1016/j.jaapos.2025.104652
Sowmya Raveendra Murthy, Sahil Sharma
{"title":"Modified Nishida's procedure combined with medial rectus recession in a case of Moebius syndrome.","authors":"Sowmya Raveendra Murthy, Sahil Sharma","doi":"10.1016/j.jaapos.2025.104652","DOIUrl":"10.1016/j.jaapos.2025.104652","url":null,"abstract":"<p><p>Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida's procedure and bimedial recession to correct large-angle esotropia.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104652"},"PeriodicalIF":1.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132207","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}