To evaluate risk factors associated with severe retinopathy of prematurity ROP (sROP) in two separate cohorts of infants.

Strabismus following other intraocular surgery has several well-described etiologies. Vitreoretinal surgeries are the most likely to require retrobulbar anesthesia and exoplants, two commonly associated risk factors for postoperative strabismus. A reliable assessment of the incidence of strabismus secondary to other ocular surgery has not been established. We report a large cohort of vitreoretinal surgery cases performed in the same multispecialty practice with the area's only adult strabismus surgeon. We specifically examined strabismus surgery as the inclusion criteria, because nonsurgical management of postoperative strabismus typically indicates more benign and less-complex presentations. We found 7 cases of strabismus surgery following 4,176 retina surgeries (0.17%), one of which had a prior history of strabismus surgery. Of the 6 others, 2 had a scleral buckle placed, and a further 2 had a course consistent with a typical block infiltration strabismus.

In cases of recurrent exotropia, medial rectus resection after bilateral lateral rectus recession is often considered for reoperations. The surgical amount of medial rectus resection is typically determined according to the standard surgical dose table; however, postoperative variability has been noted in the surgical outcomes. In the current study, medial rectus tendon width (MRTW) was measured intraoperatively, and surgical dose-response was calculated as the ratio between amount of correction and resected medial rectus. The MRTW exhibited a positive correlation with age at time of surgery and surgical dose-response. MRTW could thus merit further study as a potential intraoperative predictor of surgical dose-response when considering medial rectus resection in patients with recurrent exotropia.

Retinal arteriovenous malformations (AVMs) are rare congenital, nonhereditary vascular anomalies of the retina. We report the case of a 6-year-old child presenting with recurrent frontal headaches. Funduscopy examination revealed an AVM in the right eye, inferior to the optic nerve head. Optical coherence tomography and retinal imaging confirmed the presence of an AVM measuring 3 disk diameters. Magnetic resonance imaging of the head revealed a cavernous malformation in the right frontal subcortical region.

To measure patient satisfaction with synchronous telehealth care, we administered the Telemedicine Satisfaction Questionnaire (TSQ) to assess the quality of care provided, its similarity to face-to-face meetings, and patients' perception of the interaction.

A 21-month-old girl presented with acute-onset esotropia with unexplained fever, conjunctivitis, and rash. Sensorimotor examination revealed the presence of a left abducens nerve palsy. After cardiogenic shock, she was found to have multiple large coronary artery aneurysms and was diagnosed with incomplete Kawasaki disease. The patient eventually had near-resolution of her abducens nerve palsy with treatment for her underlying Kawasaki disease through aspirin, infliximab, and intravenous immunoglobulin therapy. Abducens nerve palsy is a rare manifestation of Kawasaki disease that may reflect a late diagnosis and an increased risk of coronary artery involvement.

Yearly vision screenings, often performed in a primary care setting, are an important part of child health for detection of ocular disorders, but there are discrepancies in referral guidelines. Whereas guidelines provide consistent failure and referral criteria for 3- and 4-year-olds, criteria for older children disagree. To investigate the effect of having discordant guidelines, we retrospectively applied each guideline threshold to a cohort of 5- to 6-year-olds who underwent visual acuity screening during a well-child encounter and compared the results to the real-life referral rates. We found a 2.7-fold difference in the proportion of 5- to 6-year-olds children failing a vision screening and a difference in referral rate of 18%. Our results demonstrate that the existence of even mildly conflicting pediatric vision screening guidelines can lead to uncertainty among primary care providers who perform vision screening in children. We hope that this study will shed light on the problem and stimulate efforts to harmonize referral criteria.

Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents is used to treat posterior type 1 retinopathy of prematurity (ROP). Recent reports indicate that anti-VEGF therapy may be associated with white matter brain injury, according to animal studies, and neurodevelopmental impairments in children born preterm. We investigated whether type 1 ROP treated with bevacizumab is associated with structural brain injury on infant term magnetic resonance images (MRIs) in very low birth weight infants compared with those treated with laser ablation.

We present a case of partial optic nerve head (ONH) avulsion in a 15-year-old boy evaluated with optical coherence tomography (OCT) from 2 weeks to 15 months after acute injury. Distinct findings on OCT in the acute setting correlated with the diagnosis and with additional testing, including fundus photography, Humphrey visual fields, and clinical examination. OCT findings became less pronounced in the chronic setting. Our case highlights that OCT may be valuable in the acute setting for evaluating ONH avulsion in certain patients; however, OCT findings are less distinct in the chronic setting.

Hereditary mucoepithelial dysplasia (HMD) is a rare autosomal dominant dysplastic dyskeratotic epithelial syndrome caused by pathogenic variants in the SREBF1 gene. This syndrome is associated with a variety of ocular conditions, including cataracts, nystagmus, keratitis, meibomian gland dysfunction (MGD), and decreased visual acuity. We report the case of a boy followed from 1 to 7 years of age who had a confirmed HMD-associated variant in the SREBF1 gene. The patient has severe MGD, with resulting keratitis and photosensitivity, and bilateral glaucoma, which has not previously been reported in association with HMD. The gene affected in HMD negatively affects gap junctions and lipid biosynthesis, which are important in the stability of the trabecular meshwork.

We investigated the relationship between self-reported history of visual impairment in youth and the development of dementia in later life using data from the Panel Study of Income Dynamics (PSID) household survey, which included the Eight-item Informant Interview to Differentiate Aging and Dementia (AD-8) screen. Adults with a reported history of childhood visual impairment were found to have significantly higher odds of positive dementia screening. After adjusting for confounders, we found a twofold increase in those reporting early visual impairment compared with those who did not report early visual impairment.

Congenital cranial dysinnervation disorders involve abberant connections between cranial nerves, often resulting in synkinetic activation of target muscles. Marcus-Gunn jaw winking ptosis and Duane retraction syndrome are some of the more well-known examples of this phenomenon. We present serial video of a child with congenital trigemino-abducens synkinesis, a lesser known congenital cranial dysinnervation disorder, to demonstrate the characteristics of this likely under-diagnosed presentation.

We present the case of a 57-year-old man with vertical diplopia who was diagnosed with acquired left eye supranuclear double depressor palsy after ischemic stroke, with small infarcts at the bilateral medial posterior thalami, left midbrain, and left occipital lobe. Given the different innervation of the two depressors, intact vestibulo-ocular reflex, and the healthy inferior rectus muscle morphology observed intraoperatively, the lesion likely involved the supranuclear vertical gaze center or its pathway. His strabismus was treated successfully with recession and resection of vertical rectus muscles, resulting in no significant deviation in either the vertical or horizontal directions in primary gaze at 6 months' follow-up.

The purpose of this case series is to consider whether preterm infants having gestational age (GA) ≥32 weeks and birth weight (BW) ≥1500 g exposed to unblended oxygen should be screened earlier than the current guidelines adopted from Kenya for the third epidemic of retinopathy of prematurity (ROP). Cases of such infants with severe, treatment-requiring ROP at St Francis Hospital Nsambya, Kampala, Uganda, were reviewed for severe ROP requiring treatment prior to 30 days of life. Since 2022, 3 infants required treatment prior to 30 days of life. All infants received unblended oxygen for 5-10 days after birth and were on room air at the time of treatment. GA ranged from 32 to 34 weeks, and all had BW >1500 g. All infants had chronological age of 2 weeks at treatment. Preterm babies who are born at GA ≥32 weeks and exposed to unblended oxygen may be at risk of developing severe, treatment-requiring ROP earlier than the adopted guidelines from other countries have suggested.

To investigate whether immigrant generation is associated with caregiver-reported receipt of vision testing.

The American Academy of Pediatrics recommends pediatric vision screening to detect and refer vision disorders during the critical early years when intervention yields the greatest benefits. We determined the rate of vision screening for US children 3-5 years of age with commercial insurance and compared rates among those living in rural versus urban areas. Children in rural compared with urban areas were expected to have lower rates of vision screening.

Stickler syndrome, a rare connective tissue disorder, presents with a broad spectrum of ocular manifestations, including myopia, vitreoretinal degeneration, glaucoma, and retinal detachment. While extensive data exists on the treatment outcomes of retinal detachment repair in Stickler syndrome, the potential risks associated with acute postoperative intraocular pressure elevation remain underexplored. We report the case of a 10-year-old boy with Stickler syndrome who underwent scleral buckling surgery and subsequently experienced ocular hypertension.