Journal of Aapos最新文献

{"title":"Beyond clinical trials: real-world predictors of amblyopia resolution in Saudi Arabian children.","authors":"Saeed Aljohani, Lama Alhandud, Reema Alhumaidan, Fatimah Alsuhibani","doi":"10.1016/j.jaapos.2026.104842","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104842","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate treatment outcomes and predictors of amblyopia resolution in children 3-10 years of age treated in public hospitals in Qassim province, Saudi Arabia.</p><p><strong>Methods: </strong>The medical records of children with unilateral amblyopia due to strabismus, anisometropia, or both, treated at four public hospitals, were reviewed retrospectively. Data was collected for records of routine clinical care (2017-2022). All patients had at least two clinical visits' records. Recorded variables included amblyopia type, baseline amblyopic-eye visual acuity, initial treatment modality, and number of follow-up visits. Complete resolution was defined as a final interocular visual acuity difference of ≤0.1 logMAR. Proportional improvement was defined as reduction in interocular visual acuity difference from baseline to final visit divided by baseline interocular difference. Multivariable logistic regression identified independent predictors of resolution.</p><p><strong>Results: </strong>A total of 198 cases were reviewed. Mean patient age was 6.8 ± 2.2 years; 50.5% were male. Overall, 99 patients (50.0%) achieved complete resolution, with a mean proportional improvement of 53.9%. Worse baseline amblyopic-eye visual acuity was associated with lower odds of resolution (adjusted odds ratio = 0.60 per 0.1 logMAR of worse baseline visual acuity; P < 0.001). Compared with glasses only, patching alone was associated with poorer outcomes (aOR = 0.38; P = 0.015), whereas combined treatment showed similar outcomes. Higher number of follow-up visits independently predicted success. Age showed a borderline association, while amblyopia type was not independently associated with resolution.</p><p><strong>Conclusions: </strong>In this study of real-world amblyopia outcomes, the first of its kind in Saudi Arabia, half of the children achieved resolution, with success strongly dependent on baseline visual acuity, initial treatment modality, and continuity of follow-up.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104842"},"PeriodicalIF":1.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787827","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":"Brown recluse bite to the eyelid: a case report.","authors":"Melissa Goldin, Sophie Pilkinton, Meghan Flemmons","doi":"10.1016/j.jaapos.2026.104820","DOIUrl":"10.1016/j.jaapos.2026.104820","url":null,"abstract":"<p><p>Brown recluse spider bites to the periorbital region have been reported rarely, particularly in pediatric patients. We report the case of a 17-year-old girl who developed periorbital and facial swelling after a brown recluse bite to the eyelid. Symptoms began within hours of the bite and progressed over the first 48 hours, leading to significant periorbital edema, chemosis, and elevated intraocular pressure (IOP). Symptoms improved 72 hours after the bite. Management included pressure-lowering eye drops, cool compresses, antihistamines, anti-inflammatories, and intravenous and oral antibiotics. IOP normalized without surgical intervention. Systemic symptoms did not occur, and swelling resolved over 2 weeks. This case highlights the potential for conservative management in cases without systemic toxicity or tissue necrosis and emphasizes the importance of monitoring for ocular complications in periorbital envenomation.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104820"},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624498","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":"Delayed removal of a cat claw from the caruncle of a pediatric patient.","authors":"Neetin H Prabhu, Bashar M Bata","doi":"10.1016/j.jaapos.2026.104819","DOIUrl":"10.1016/j.jaapos.2026.104819","url":null,"abstract":"<p><p>Periocular injuries secondary to animal scratches in in children can be dangerous and associated with high morbidity. We present a case of a delayed extrusion of a cat claw from the caruncle of a pediatric patient 11 days after the initial injury. The patient was seen immediately after the injury in the emergency department, when no foreign bodies were noted. He returned to the same emergency department after partial spontaneous extrusion. The claw was removed by the ophthalmology service.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104819"},"PeriodicalIF":1.3,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624510","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":"Innovative nonsurgical treatment for central-peripheral rivalry–type diplopia","authors":"Lindsay D. Klaehn CO, COMT ,&nbsp;Tia B. Bodi CO, COMT ,&nbsp;Andrea M. Kramer CO(R), COMT ,&nbsp;Raymond Iezzi Jr. MD ,&nbsp;David O. Hodge MS ,&nbsp;Erick D. Bothun MD","doi":"10.1016/j.jaapos.2026.104757","DOIUrl":"10.1016/j.jaapos.2026.104757","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate whether a multifocal contact lens improves central-peripheral rivalry–type (CPR-type) diplopia in patients with epiretinal membrane and other maculopathies.</div></div><div><h3>Methods</h3><div>Seventeen consecutive adult patients with epiretinal membrane or macular hole and CPR-type diplopia were enrolled. A multifocal, center-distance contact lens, with +2.50 bifocal power, was applied to the eye with macular disease. Measurements of diplopia (optotype-frame test), metamorphopsia (M-Charts, Amsler grid), and aniseikonia (Awaya test) were obtained prior to contact lens placement on the affected eye and repeated 30 minutes after contact lens placement.</div></div><div><h3>Results</h3><div>Median best-corrected visual acuity in the affected eye(s) was 20/20 Snellen before and after multifocal contact lens placement. Diplopia improved in 10 patients (59%), from describing double letters in a single frame or a single letter in a double frame (both indicating central-peripheral rivalry) to a single letter in a single frame. Sixteen patients (94%) reported subjective improvement in M-Chart metamorphopsia (mean of 0.46 before treatment to 0.19 with the multifocal contact lens [mean difference, 0.27; 95% CI, 0.15-0.33; <em>P</em> ≤ 0.001]). Thirteen (76%) showed improvement on the Amsler grid: perceived grid distortion changed from a mean of 111.8 boxes to 38.2 boxes (mean difference, 73.6; 95% CI, 16.67-30.5; <em>P</em> = 0.024). Additionally, 10 (59%) demonstrated improvement in Awaya test aniseikonia, with a mean change from 4.4% to 3.6% (mean difference, −0.82; 95% CI, −1.66 to 0.02; <em>P</em> = 0.53).</div></div><div><h3>Conclusions</h3><div>Multifocal contact lenses present a promising alternative for alleviating CPR-type diplopia and reducing metamorphopsia associated with epiretinal membrane and macular hole by functionally masking the periphery while maintaining clear central vision.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104757"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229652","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":"Congenital cystic eye and coloboma with a cyst hybrid phenotype: a developmental continuum","authors":"Lily C. Farrell MD ,&nbsp;Ari H. August BA ,&nbsp;Angela N. Viaene MD ,&nbsp;Diana Kim MD ,&nbsp;Karuna Shekdar MD ,&nbsp;Ralph C. Eagle Jr. MD ,&nbsp;Karen Revere MD ,&nbsp;Tatyana Milman MD","doi":"10.1016/j.jaapos.2026.104800","DOIUrl":"10.1016/j.jaapos.2026.104800","url":null,"abstract":"<div><div>A 2-day-old boy presented with a large orbital mass, which showed radiological and pathological overlap between congenital cystic eye (CCE) and coloboma with cyst (CwC). Initially identified on prenatal imaging at 21 weeks, the patient underwent postnatal clinical and radiologic evaluation followed by histopathologic analysis of the enucleated eye. The coexistence of both anomalies within a single globe challenges the traditional view of CCE and CwC as distinct entities and supports a unifying theory of a developmental spectrum of early ocular malformations.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104800"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488210","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":"Information for Readers","authors":"","doi":"10.1016/S1091-8531(26)00098-4","DOIUrl":"10.1016/S1091-8531(26)00098-4","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104825"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147757098","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":"A rare case of infantile dacryoadenitis: a case report","authors":"Annie Zhang BA ,&nbsp;Catherine J. Choi MD, MS","doi":"10.1016/j.jaapos.2026.104758","DOIUrl":"10.1016/j.jaapos.2026.104758","url":null,"abstract":"<div><div>A 10-month-old boy, otherwise healthy, presented with significant left upper eyelid edema, erythema, and near-complete ptosis. He was afebrile and nontoxic. Examination revealed an inflamed lacrimal gland, with no other orbital signs. There was mild leukocytosis and elevated ESR and CRP. Intravenous ampicillin/sulbactam was initiated. Forty-eight hours later, the contralateral eyelid developed similar symptoms. Blood cultures, respiratory viral panel, COVID-19 antigen, and EBV serologies were negative. Orbital imaging revealed moderate bilateral lacrimal gland enlargement without abscess or other abnormalities. The patient’s symptoms steadily improved, and therapy was transitioned to oral antibiotics, ibuprofen, and topical steroids. CRP and leukocytosis peaked at 11 and 18 days after presentation, respectively, and subsequently normalized. Pediatric rheumatology consultation did not identify any underlying systemic cause, and tissue biopsy was not pursued. The child recovered completely and remains asymptomatic. This case highlights a rare presentation of bilateral dacryoadenitis in infancy. We discuss the relevant inflammatory markers that can be used to differentiate between various infectious and inflammatory etiologies.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104758"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259919","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":"Crizotinib-associated nodular scleritis in an adolescent","authors":"Mennatullah Elfwwal MD ,&nbsp;Douglas S. Hawkins MD ,&nbsp;Laura C. Huang MD","doi":"10.1016/j.jaapos.2026.104760","DOIUrl":"10.1016/j.jaapos.2026.104760","url":null,"abstract":"<div><div>We report the case of a 17-year-old girl with history of anaplastic large-cell lymphoma on crizotinib therapy who presented with pain and blurred vision in the left eye. Examination demonstrated nodular non-necrotizing anterior scleritis in the left eye. The patient initially improved with oral glucocorticoid treatment until she developed nodular non-necrotizing anterior scleritis in the right eye during taper of this medication. Discontinuation of crizotinib allowed the patient to taper off glucocorticoid treatment, with subsequent resolution of scleritis.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104760"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322502","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":"Demographics and costs of pediatric blepharitis and conjunctivitis seen in California emergency departments over a 10-year period","authors":"Jonathan R. Morse BA, MPH ,&nbsp;Albert Xu BS ,&nbsp;John M. Nesemann MD ,&nbsp;Jeremy D. Keenan MD, MPH ,&nbsp;Julius T. Oatts MD","doi":"10.1016/j.jaapos.2026.104790","DOIUrl":"10.1016/j.jaapos.2026.104790","url":null,"abstract":"<div><h3>Background</h3><div>Every year, thousands of children use the emergency department (ED) for low-acuity conditions. This study aimed to determine the financial impact of ED utilization for the most common nonemergent ocular conditions, blepharitis and conjunctivitis, and to explore the demographics of patients seeking care for these conditions through the ED.</div></div><div><h3>Methods</h3><div>All cases of pediatric blepharitis and conjunctivitis between January 1, 2012, and December 31, 2021, were identified using the California Office of Health Care Access Information Database. Cases were analyzed under different billing structures including care rendered in the emergency department (ED) versus outpatient settings using evaluation and management (E&amp;M) and eye visit codes.</div></div><div><h3>Results</h3><div>Blepharitis and conjunctivitis accounted for 306,417 visits, or 78.2% of all ED eye-related visits among children ≤18 years. The most common self-reported race/ethnicity was Hispanic (56.3%), followed by White (20.1%) and Black (13.0%). Most patients had public insurance (72.7%) or private insurance (19.7%). ED utilization was 17.6% higher during weekends. Estimated costs for ED visits totaled $36,567,192-$37,914,508 annually. Estimated annual outpatient costs using new patient E&amp;M codes totaled $1,146,612- $2,303,337, and the estimated annual outpatient costs using eye visit codes totaled $1,138,339-1,525,344. This suggests the cost of ED care was 16.5-32.1 times more expensive than equivalent outpatient costs.</div></div><div><h3>Conclusions</h3><div>Care provided in the ED for blepharitis and conjunctivitis may be 16.5-32.1 times more expensive than care rendered in outpatient settings. Non-White children and children with public insurance had higher ED utilization compared to their population-level representation. Increasing access to pediatric eye specialists and decreasing ED utilization has the potential to improve efficacy while promoting childhood health outcomes.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104790"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436923","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":"Clinical characteristics and quality of life measures in children with glaucoma-suspect or glaucoma diagnoses in chronic, noninfectious uveitis","authors":"Virginia Miraldi Utz MD ,&nbsp;Amy Cassedy PhD ,&nbsp;Minal Aundhia MD ,&nbsp;Alexandra Duell BS ,&nbsp;Megan Quinlan-Waters BS ,&nbsp;Adam H. Kaufman MD ,&nbsp;Sheila Angeles-Han MD, MSc","doi":"10.1016/j.jaapos.2026.104804","DOIUrl":"10.1016/j.jaapos.2026.104804","url":null,"abstract":"<div><h3>Background</h3><div>The impact of glaucoma-suspect or glaucoma diagnoses on quality of life (QOL) outcomes in children with noninfectious uveitis (NIU) has not been well characterized. This study evaluated the impact of glaucoma-related diagnoses on vision-related QOL (VRQOL) and vision-related functioning (VRF) using the Effects of Youngsters’ Eyesight on QOL (EYE-Q), overall QOL (Pediatric QOL Inventory: PedsQL), and anxiety and depression (Revised Children’s Anxiety and Depression: RCAD).</div></div><div><h3>Methods</h3><div>Children with chronic, NIU were categorized as no glaucoma (Gla⁻) and glaucoma-suspect or glaucoma (Gla⁺) for QOL analysis. Demographic and clinical data were collected. Patients and parents/proxies completed the EYE-Q, PedsQL, and RCADS. Statistical analyses were performed, with significance defined at <em>P &lt;</em>0.05.</div></div><div><h3>Results</h3><div>Seventy-six children (mean age, 10.7 ± 4.6 years; 71% female) were included, 36 (47%) with glaucoma-related diagnoses (Gla⁺). Most had bilateral (82%), anterior (91%) NIU and were associated with juvenile idiopathic arthritis (JIA) (67%). Children with JIA were less likely to develop Gla⁺. Affected eyes with glaucoma had more complications at NIU diagnosis (<em>P</em> = 0.003), including synechiae (<em>P &lt;</em>0.001) and cataracts (<em>P &lt;</em> 0.001), compared with the Gla⁻ group. While Gla⁺ children had lower QOL scores than Gla⁻ children, these differences were not statistically significant. However, parents of Gla⁺ children reported poorer VRF (<em>P</em> = 0.017), lower total EYE-Q scores (<em>P</em> = 0.013), and higher RCADS scores (<em>P</em> = 0.041), which persisted over time.</div></div><div><h3>Conclusions</h3><div>Non-JIA uveitis and eyes with complications at uveitis presentation are more likely to develop glaucoma-related diagnoses. Parents/proxies of children with Gla⁺ reported lower QOL scores in both eye-specific and psychosocial functioning, highlighting the need for behavioral health interventions.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"30 2","pages":"Article 104804"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500165","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}