J AAPOS [JOURNAL]
Sun
200 papers
Defining and measuring population-level amblyopia treatment outcomes: a proposal by the AAPOS Vision Screening and Research Committees.
Arnold RW, Birch E, Bradford G … +13 more , Collins M, Donahue SP, Gaier ED, Ghasia F, Greninger DA, Hutchinson AK, Jastrzembski B, Kemper AR, O'Neil J, Pineles S, Rotruck J, Wang B, Wygnanski-Jaffe T
J AAPOS · 2025 Aug · PMID 40449829 · Publisher ↗
Ophthalmic professional organizations such as the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) strive to support the optimal detection, prevention, and treatment of amblyopia to reduce the comm...
Ophthalmic professional organizations such as the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) strive to support the optimal detection, prevention, and treatment of amblyopia to reduce the community burden of vision loss. To support population-level monitoring with regard to outcomes of childhood amblyopia screening and treatment, the AAPOS Vision Screening and the Research committees propose a set of guidelines for assessing population prevalence of persistent vision impairment due to amblyopia. The committees defined "residual amblyopia" as persistent vision impairment with best-corrected visual acuity worse than logMAR 0.3 (20/40) in one eye with an interocular difference, or visual acuity worse than logMAR 0.3 in both eyes, attributable to unilateral or bilateral amblyopia respectively, with visual acuity deficits not due to other organic causes. Epidemiological assessment of residual amblyopia should be made at an age when amblyopia should have already been detected and treated (8 years). A standardized assessment of residual amblyopia has the potential to promote public health interventions, including quality-improvement projects, for amblyopia screening and subsequent treatment.
"My child can't see"-workup and management of children with low vision: a joint workshop of the AAPOS Low Vision Rehabilitation and Genetic Eye Diseases Committees.
Ditta L, Utz VM, Chandna A … +5 more , Drack A, Reynolds M, Weed M, Dumitrescu A, Chang MY
J AAPOS · 2025 Jun · PMID 40441479 · Full text
Children with visual impairment present a unique challenge to pediatric ophthalmologists. Diagnostic workup may include tests that require specialized interpretation, such as genetic testing and neuropsychological assess...
Children with visual impairment present a unique challenge to pediatric ophthalmologists. Diagnostic workup may include tests that require specialized interpretation, such as genetic testing and neuropsychological assessments. The differential diagnosis includes rare conditions, such as certain inherited retinal disorders, as well as more common conditions, such as cerebral/cortical visual impairment. Management of children with visual impairment requires ophthalmologists to become familiar with visual prognosis associated with various conditions and supports available for children with low vision, which vary by age. Younger children benefit from early intervention services, which may include pre-braille skills and orientation and mobility training. Older children require counseling with regard to driving, independent skills, and transition to adult care. This workshop provides detailed discussion of differential diagnoses, diagnostic tests, and management strategies in infants and older children with visual impairment. We emphasize the importance of a multidisciplinary approach, since vision impacts development in multiple domains, and many children with visual impairments are multiply disabled.
A pediatric case of significant oculocardiac reflex activation with orbital edema.
Kincaid B, Chauhan M, Goei S … +1 more , Mehta R
J AAPOS · 2025 Aug · PMID 40436263 · Publisher ↗
Oculocardiac reflex activation is a rare potential cause of severe hypotensive and/or bradycardic events that threaten hemodynamic stability. It is typically observed after facial trauma, but it can also result from edem...
Oculocardiac reflex activation is a rare potential cause of severe hypotensive and/or bradycardic events that threaten hemodynamic stability. It is typically observed after facial trauma, but it can also result from edema secondary to orbital pseudotumor and myositis, sarcoidosis, IgG4 disease, and Graves' orbitopathy. A previously healthy 10-year-old girl with no history of trauma presented with a 2-week history of right eyelid swelling, "drooping," and photophobia, with significant bradycardia on lateral gaze. She did not tolerate initial eye examination because of worsening bradycardia, which required admission. Extraocular muscle biopsy revealed scarring and fibrosis of the right lacrimal gland and medial rectus muscle. She was found to have elevated serum IgG4 level and was treated with intravenous methylprednisolone, with subsequent improvement in her hemodynamic status.
Evaluation of the QuickSee portable autorefractor system in a pediatric population.
Loayza A, Lewis A, Trivedi RH … +5 more , Gouvea L, Bowsher JD, Wolf B, Hernandez V, Peterseim MMW
J AAPOS · 2025 Jun · PMID 40414282 · Full text
PURPOSE: To evaluate the QuickSee platform's ability to detect and measure refractive error relative to gold standard cycloplegic retinoscopy in a pediatric population in a clinical setting. METHODS: Children 3-17 years...
PURPOSE: To evaluate the QuickSee platform's ability to detect and measure refractive error relative to gold standard cycloplegic retinoscopy in a pediatric population in a clinical setting. METHODS: Children 3-17 years of age underwent visual acuity screening, autorefraction by the QuickSee (QS) or QuickSee Free (QSF), and complete ophthalmic examination, including cycloplegic retinoscopy and refraction. The agreement of the results was evaluated by Bland-Altman plots. Sensitivity and specificity for detecting myopia, anisometropia, and astigmatism were calculated based on modified Orinda and AAPOS 2021 guidelines. The overall accuracy of detecting refractive error was analyzed with receiver operating characteristic curves. RESULTS: A total of 157 children (mean age, 7.58 ± 2.62 years) underwent autorefraction by the QS system (QS/QSF), with a testability of 98.1%. Moderate-to-good agreement was seen in spherical equivalent (SE) and J between the QS system and retinoscopy. The slightly negative bias for SE and J suggests underestimation of QS measurements relative to retinoscopy. The area under curve was >0.9 for all definitions of hyperopia, myopia, and astigmatism. The QS system had sensitivities and specificities >0.8 for hyperopia, myopia, and astigmatism at all levels of refractive error considered. Using modified Orinda and AAPOS 2021 referral guidelines, the QS system demonstrated sensitivities of 89.2% and 94.4%, and specificities of 56.5% and 68.6%, respectively. CONCLUSIONS: In our pediatric study cohort, the QS system effectively identified significant refractive error.
Area deprivation index predicts follow-up in retinopathy of prematurity.
Tanenbaum RE, Mokhashi N, Warren AK … +3 more , Blair MP, Beniwal S, Rodriguez SH
J AAPOS · 2025 Jun · PMID 40412753 · Publisher ↗
BACKGROUND: The risk of progression or development of retinopathy of prematurity (ROP) persists after hospital discharge, and successful outpatient follow-up requires extensive coordination. This study aimed to evaluate...
BACKGROUND: The risk of progression or development of retinopathy of prematurity (ROP) persists after hospital discharge, and successful outpatient follow-up requires extensive coordination. This study aimed to evaluate the impact of social drivers of health on attendance at outpatient ROP examinations using an area deprivation index (ADI), a census-based composite score indicating neighborhood affluence and opportunity. METHODS: The medical records of infants evaluated for ROP between January 1, 2016, and May 1, 2023, at the University of Chicago Medical Center were reviewed. The following demographic data were extracted from the record: birth weight, gestational age, sex, race, ethnicity, and insurance status. ADI was calculated based on available maternal demographic data. Univariate and multivariable logistic regressions were performed to evaluate predictors of missed first outpatient appointment. RESULTS: A total of 540 infants who were evaluated during the study period required additional ROP examinations after discharge. Of these, 174 patients (32%) missed their first outpatient appointment, and 14 (2.6%) did not complete their ROP evaluations. For each level increase in ADI, adjusted odds of missing initial follow-up increased by 17% (95% CI, 7%-28%; P < 0.001). Although race/ethnicity was associated with missed follow-up on unadjusted analyses, the apparent relationship became nonsignificant after adjusting for ADI (OR = 1.21; 95% CI, 0.51-2.88; P = 0.663). CONCLUSIONS: In our study cohort, patients with high ADI scores, indicating neighborhood disadvantage, were at higher risk of missed outpatient follow-up during the acute phase of ROP evaluation.
Periodic alternating esotropia associated with disorders of neural tube closure.
Lewis JR, Malem AH, Buncic JR
J AAPOS · 2025 Jun · PMID 40409457 · Publisher ↗
PURPOSE: To report a series of children with periodic alternating esotropia (PAE) in the context of neural tube defects and hydrocephalus. METHODS: The medical notes of all patients presenting with a periodic alternating...
PURPOSE: To report a series of children with periodic alternating esotropia (PAE) in the context of neural tube defects and hydrocephalus. METHODS: The medical notes of all patients presenting with a periodic alternating esotropia over a 20-year period were reviewed for details of ocular motility characteristics and underlying associated neurological pathology. Previously published cases are also reviewed. RESULTS: A total of 5 patients with PAE were identified. In all 5, PAE occurred in combination with periodic alternating gaze paresis (PAG) with contraversive head turn. The abducting eye was always preferred for fixation. All patients were born with neural tube defects, associated with hydrocephalus requiring ventriculoperitoneal shunt insertion in the first month of life. CONCLUSIONS: These 5 cases, in combination with 5 previously published cases, describe a rare but consistent collection of ocular motility abnormalities, which seem to indicate a genuine clinical entity in some patients with neural tube closure defects. PAE should be considered in patients with a neural tube defect and a head turn.
Demographic disparities in the prevalence of pediatric corneal neovascularization cases at a tertiary care center.
Valadez J, Arreguin AJ, Padovani-Claudio DA
J AAPOS · 2025 Jun · PMID 40403960 · Publisher ↗
Demographic data for pediatric patients with corneal neovascularization is scarce, hampering assessment of underlying causes. In our retrospective, single-center case series, we found that corneal neovascularization was...
Demographic data for pediatric patients with corneal neovascularization is scarce, hampering assessment of underlying causes. In our retrospective, single-center case series, we found that corneal neovascularization was relatively more common in female, Hispanic, and Black patients. We identified blepharokeratoconjunctivitis spectrum diseases as the most commonly associated condition. We also identified important markers of health care use, showing high numbers of specialty visits, medication prescriptions, years of disease burden, and disease sequelae (ocular hypertension, amblyopia, and visual impairment) within our cohort. Ultimately, our results highlight that the burden of corneal neovascularization may not be shouldered equitably within our pediatric patients. These inequities in children can compound and potentiate existing health and social disparities.
Clinical profile of patients with monocular elevation deficiency undergoing strabismus surgery.
Akbari MR, Masoomian B, Azizi E … +4 more , Mahmood MO, Mirmohammadsadeghi A, Majdi A, Khorrami-Nejad M
J AAPOS · 2025 Jun · PMID 40379019 · Publisher ↗
PURPOSE: To provide a comprehensive evaluation of the visual, refractive, and strabismic characteristics of patients with monocular elevation deficiency (MED) undergoing strabismus surgery. METHODS: The medical records o...
PURPOSE: To provide a comprehensive evaluation of the visual, refractive, and strabismic characteristics of patients with monocular elevation deficiency (MED) undergoing strabismus surgery. METHODS: The medical records of patients at a single institution who were diagnosed with and underwent surgery for MED were reviewed retrospectively. Visual acuity, refractive error, angle of deviation, abnormal head posture (AHP), presence of ptosis, prevalence of amblyopia and strabismic patterns were analyzed, with MED eyes compared with fellow eyes. RESULTS: A total of 105 patients were included. Mean cylindrical refractive error was significantly higher in MED eyes compared with fellow eyes (-1.40 ± 1.70 D vs -0.62 ± 1.00 D [P < 0.001]). Mean spherical equivalent was 0.25 ± 2.32 D in MED eyes and 0.66 ± 1.41 D in fellow eyes (P = 0.014). In 67 patients with visual acuity measurements, mean corrected distance visual acuity in MED eyes was significantly worse than in fellow eyes (0.18 ± 0.20 vs 0.05 ± 0.11 logMAR [P < 0.001]). Forty patients (60%) had unilateral amblyopia, 38 in the MED eye. The most common type of deviation was hypotropia alone (50%), followed by hypotropia with exotropia (33%) and hypotropia with esotropia (17%). Pure chin-up was the most frequent type of AHP, in 31 of 36 patients with an AHP (86%). Ptosis in the MED eye was observed in 89 patients (85%). CONCLUSIONS: Our findings highlight the variety of clinical presentations in a relatively large cohort of patients with MED undergoing strabismus surgery.
Visual and refractive outcomes up to 5 years of age of dome-shaped macula detected by handheld spectral domain optical coherence tomography in preterm infants.
Adan NM, Ohan M, Wu JG … +7 more , Ding L, Legocki AT, Gillette TB, Shariff A, Grant LE, Tarczy-Hornoch K, Cabrera MT
J AAPOS · 2025 Jun · PMID 40379018 · Full text
PURPOSE: To evaluate long-term visual and refractive outcomes in preterm infants found to have dome-shaped macula on imaging with handheld spectral domain optical coherence tomography (SD-OCT). METHODS: This was a prospe...
PURPOSE: To evaluate long-term visual and refractive outcomes in preterm infants found to have dome-shaped macula on imaging with handheld spectral domain optical coherence tomography (SD-OCT). METHODS: This was a prospective, observational study of preterm infants. Awake handheld SD-OCT was performed at the time of each routine retinopathy of prematurity examination. All visual and refractive (cycloplegic refraction by streak retinoscopy) outcomes were assessed by a single, masked, fellowship-trained pediatric ophthalmologist at 9 months, 2 years, and 5 years of age. RESULTS: Of 95 included preterm infants (52% male; mean birth weight, 1006.14 ± 292.96 g; mean gestational age, 28.38 ± 2.87 weeks), 58 (61%) had dome-shaped macula in at least one eye with good kappa agreement (0.71 ± 0.04; 95% Cl, 0.63-0.80). No differences in spherical equivalent were seen at 9 months (+1.80 ± 1.67 vs +1.55 ± 1.89 [P = 0.39]), 2 years (+1.34 ± 1.89 vs +1.03 ± 1.20 [P = 0.60]), or 5 years of age (+0.51 ± 1.51 vs +0.72 ± 1.66 [P = 0.12]). There were also no differences in logMAR visual acuity at 9 months (P = 0.41), 2 years (P = 0.62), or 5 years (P = 0.60) of age. Rates of astigmatism or strabismus did not differ at any time point (P > 0.10). CONCLUSIONS: Dome-shaped macula detected by handheld SD-OCT in infancy was not associated with differences in visual acuity, refractive error, or strabismus at 9 months, 2 years, or 5 years of age.
Geographic distribution and coverage of pediatric ophthalmologists in the United States.
Franco JJ, Shapiro JN, Johnson-Griggs MA … +1 more , Mian SI
J AAPOS · 2025 Jun · PMID 40379017 · Publisher ↗
The United States faces a persistent shortage of pediatric ophthalmologists (POs). Improved characterization of the geographic distribution and reach of providers is needed to inform health policy, trainee recruitment, a...
The United States faces a persistent shortage of pediatric ophthalmologists (POs). Improved characterization of the geographic distribution and reach of providers is needed to inform health policy, trainee recruitment, and care delivery efforts. We use drive time-based service area analysis to characterize the geographic coverage of POs in the United States and show that 1 in 7 American children live outside 60 minutes of PO care, with reduced access associated with several demographic variables.
Traumatic bilateral optic nerve avulsion in a teen.
Jayadev C, Gandhi P, Aravind A … +1 more , Nagesha Ck
J AAPOS · 2025 Jun · PMID 40379016 · Publisher ↗
A 16-year-old boy presented with bilateral vision loss with severe facial and head injuries after a road traffic accident. Vision was no light perception in both eyes. Examination revealed a complete optic nerve avulsion...
A 16-year-old boy presented with bilateral vision loss with severe facial and head injuries after a road traffic accident. Vision was no light perception in both eyes. Examination revealed a complete optic nerve avulsion on the right side and a complete optic nerve avulsion with an intact nerve sheath attachment on the left side, confirmed by B-scan ultrasonography and magnetic resonance imaging. Follow-up visits showed extensive posterior pole gliosis in both eyes. This report emphasizes the critical importance of understanding the severity of injury and the underlying pathomechanism of bilateral optic nerve avulsion, which is associated with a uniformly poor visual prognosis.
Fibroadipose vascular anomaly in the orbital region.
Zamorano M, Ventas-Ayala B, Reguero ME … +1 more , Sales-Sanz M
J AAPOS · 2025 Jun · PMID 40379015 · Publisher ↗
Fibroadipose vascular anomaly (FAVA) is an intramuscular vascular anomaly where venous ectasia and muscle is replaced by fibroadipose tissue. It typically affects adolescents and young adults, who experience pain and swe...
Fibroadipose vascular anomaly (FAVA) is an intramuscular vascular anomaly where venous ectasia and muscle is replaced by fibroadipose tissue. It typically affects adolescents and young adults, who experience pain and swelling, primarily in distal muscles, such as the calf and forearm. We present a case of FAVA affecting the orbital region, posing diagnostic and management challenges. Surgical intervention was successful, with no recurrence over 2 years' follow-up.
Utility, safety, and accessibility of phone call follow-up in strabismus surgery postoperative care.
Shao CG, Morales N, Lee AR
J AAPOS · 2025 Jun · PMID 40355077 · Publisher ↗
BACKGROUND: Strabismus surgery follow-up is used to identify postoperative complications and assess surgical outcomes. Traditionally, follow-ups at our center required in-person postoperative week 1 (POW1) visits. Common...
BACKGROUND: Strabismus surgery follow-up is used to identify postoperative complications and assess surgical outcomes. Traditionally, follow-ups at our center required in-person postoperative week 1 (POW1) visits. Common obstacles to completing clinic visits include work conflicts and transportation challenges. The purpose of this study was to investigate the safety, cost-effectiveness, and potential for improving healthcare access of phone call follow-ups instead of in-person follow-ups at POW1. METHODS: We retrospectively reviewed data from 370 consecutive strabismus surgery patients between mid-2018 and 2021. Successful POW1 follow-up was defined as an attended in-person visit or completion of a standardized phone questionnaire. RESULTS: Of 188 scheduled in-person POW1 visits, 179 were successful. Of the 182 scheduled phone POW1 follow-ups, 175 were successful (95.2 vs 96.2% successes [P = 0.66]). Of 148 POW1 in-person visits with another follow-up within 6 months, 9 complications were identified. Of 150 POW1 phone follow-ups with another follow-up within 6 months, 7 complications were identified. There were no missed complications noted at postoperative month 3. No complications resulted in vision loss. The phone follow-up group traveled an average distance of 70.0 miles; the in-person group, 45.9 miles. Overall, 44.1% of patients had to travel >50 miles for their postoperative visits. CONCLUSIONS: In our study cohort, POW1 phone call follow-ups after strabismus surgery maintained patient engagement and had equivalent rates of complication detection to in-person follow-up. Implementing phone calls for early follow-up has the potential to improve healthcare accessibility for patients who travel long distances.
Incidence of orbital cellulitis in children: a population-based study.
Vloka CN, Summers RC, DeSantis D … +1 more , Hink EM
J AAPOS · 2025 Jun · PMID 40355076 · Publisher ↗
PURPOSE: To quantify the incidence of orbital cellulitis (OC) according to age, sex, race, and ethnicity among children in Colorado and to project the incidence rate and burden of OC to the national level. METHODS: This...
PURPOSE: To quantify the incidence of orbital cellulitis (OC) according to age, sex, race, and ethnicity among children in Colorado and to project the incidence rate and burden of OC to the national level. METHODS: This was a retrospective observational surveillance study of patients <18 years of age with clinically and radiographically confirmed OC from Colorado from January 1, 2018, to December 31, 2022. RESULTS: We identified 185 clinically and radiographically confirmed cases of OC in an at-risk population of 6,215,564 person-years. The crude rate and age adjusted incidence rate (ASR) of OC were 2.98/100,000 and 3.00/100,000, respectively. Five-year-old patients had the highest age-specific incidence rate (ASIR) of OC (5.97/100,000), whereas those <1 year of age, as well as 16- and 17-year-old patients had a significantly lower ASIR of 0.64/100,000, 0.27/100,00, and 0.82/100,000 respectively (P < 0.05). Males were affected twice as commonly as females (ASR = 3.99/100,000 vs 1.96/100,000, resp. [P < 0.05]). Incidence of OC was significantly higher in Black/African American (Black/AA) as compared with White children (ASR = 4.95 vs 2.89/100,000 [P < 0.05]). The ASR was higher among non-Hispanic/Latino (non-H/L) than Hispanic/Latino (H/L) children (ASR = 3.50/100,000 vs 1.97/100,000 [P < 0.05]). Projecting to the national level, the ASR of OC was estimated to be 3.21/100,000, and the estimated burden of pediatric OC in the United States was 2,331 cases/year. CONCLUSIONS: The ASR of orbital cellulitis is 3.00/100,000 in Colorado and approximated to be 3.21/100,000 in the United States. The incidence rate is highly dependent on age, sex, race, and ethnicity.
A one-year prospective study of chorioretinal scars and optic disk characteristics in children with congenital Zika syndrome.
Martins TT, Ventura CV, Aragão IO … +9 more , Medeiros LM, Netto AC, Teixeira NS, Gois AL, Carvalho AF, Higino TM, Ventura LO, Maia M, Muccioli C
J AAPOS · 2025 Jun · PMID 40355075 · Publisher ↗
PURPOSE: To evaluate early changes of chorioretinal scars and optic disk in congenital Zika syndrome (CZS). METHODS: This prospective cohort study included 35 eyes of children with CZS who presented with chorioretinal sc...
PURPOSE: To evaluate early changes of chorioretinal scars and optic disk in congenital Zika syndrome (CZS). METHODS: This prospective cohort study included 35 eyes of children with CZS who presented with chorioretinal scars, which were assessed by retinal imaging at diagnosis and at 1 year's follow-up. ImageJ software was used to measure the chorioretinal scar area. A comparison board was created to classify the lesions with regard to pigmentation. The vertical (v) and horizontal (h) cup:disk ratios (CDRs) were rated, and the CDR means at baseline and follow-up were analyzed. Ocular ultrasounds were performed to calculate the ocular growth rate and to compare with the chorioretinal scar growth rate. RESULTS: The mean area of the chorioretinal scar at baseline and at 1 year later were 8.62 and 9.41 mm, respectively (P < 0.001). The chorioretinal scar area increased in 32 eyes (91%) eyes, and pigmentation increased in 14 eyes (40%) eyes. The mean growth rate of the chorioretinal scar was 14.9% ± 21.5%. The vCDR presented a 4% increase (range, 0.15%-1%; P = 0.030) and the hCDR remained stable (range, 0.10%-1%; P = 0.530). No significant correlation was found between the vCDR (r = 0.272, P = 0.115) or hCDR (r = 0.106, P = 0.543) and chorioretinal scar growth. No correlation was observed between the chorioretinal scar growth rate and the ocular globe growth rate (r = 0.18; P = 0.63). CONCLUSIONS: In our CZS study cohort, chorioretinal scars exhibited slight changes, including growth and increase in pigmentation after 1 year. A significant increase of the vCDR was also observed. Further research is needed to determine if these changes signify disease progression.
Types of strabismus and strabismus surgery after retinal detachment repair: a health registry database analysis.
Soetikno BT, Tran EM, Wai KM … +3 more , Mruthyunjaya P, Rahimy E, Koo EB
J AAPOS · 2025 Jun · PMID 40355074 · Full text
PURPOSE: To examine the rate of diplopia, strabismus, and interventions for strabismus after pneumatic retinopexy, scleral buckle, and pars plana vitrectomy with and without scleral buckle for primary repair of rhegmatog...
PURPOSE: To examine the rate of diplopia, strabismus, and interventions for strabismus after pneumatic retinopexy, scleral buckle, and pars plana vitrectomy with and without scleral buckle for primary repair of rhegmatogenous retinal detachment (RRD). METHODS: This retrospective cohort study draws on deidentified EHR data of over 126 million patients in the TriNetX Analytics platform, a federated health research network. Subjects were assigned to three cohorts: pneumatic retinopexy (PR) alone, scleral buckle (SB) alone, or pars plana vitrectomy with or without scleral buckle (PPV+/-SB). Univariate analyses and propensity score matching (PSM) sensitivity analyses were conducted. Main outcomes were the risk of diplopia, strabismus, sensorimotor examination, or strabismus interventions, including chemodenervation or surgery. Kaplan-Meier analysis was performed. RESULTS: A total of 25,169 subjects were identified: PR (n = 1,646), SB (n = 3,658), and PPV+/-SB (n = 19,865). SB had the highest rates of diplopia (2.73%) and strabismus (1.79%), followed by PPV+/-SB (diplopia, 2.28%; strabismus, 1.46%) and PR (diplopia, 1.54%; strabismus, 0.612%). SB and PPV+/-SB had a significantly higher risk of diplopia (P < 0.01) and strabismus (P < 0.001) compared to PR. No significant differences were observed between PPV+/-SB and SB (P = 0.106 and P = 0.139). Kaplan-Meier analysis indicated SB had the highest hazard during the first year after surgery. Strabismus interventions were rare, with surgery in ≤0.27% of the SB cohort, 0.22% of the PPV+/-SB cohort, and ≤0.61% of the PR cohort. No subjects underwent chemodenervation. CONCLUSIONS: The risk of diplopia and strabismus after RRD treatments is low. SB carries the highest risk, followed by PPV+/-SB and PR. These findings support informed decision making in selecting RRD repair techniques.
Assessing the competitiveness of applicants in the ophthalmology match based on interest in pediatric ophthalmology.
Cubells C, Martinez P, Heilenbach N … +2 more , Lee TF, Elkin Z
J AAPOS · 2025 Jun · PMID 40355073 · Publisher ↗
BACKGROUND: The number of pediatric ophthalmology and strabismus (PO&S) fellowship positions filled each year remains consistently lower compared with other subspecialities. It is unclear where along the recruitment path...
BACKGROUND: The number of pediatric ophthalmology and strabismus (PO&S) fellowship positions filled each year remains consistently lower compared with other subspecialities. It is unclear where along the recruitment pathway trainees interested in pediatrics decide to select other subspecialities. This study assesses for differences in the competitiveness of ophthalmology residency applicants based on interest in PO&S, which may impact their ability to matriculate into residency. METHODS: We reviewed the 2022-2023 San Francisco (SF) Match applications submitted to a single ophthalmology residency program. Stated fellowship interest, demographic characteristics, academic performance, research activities, and other selection factors were recorded. The χ and Mann-Whitney U tests were used to compare categorical and continuous variables, respectively. RESULTS: Of the 631 applications reviewed, 125 (19.8%) of applicants stated a subspeciality interest. Among those who stated an interest, 34 (27.2%) were interested in PO&S. When compared to all other applicants (with or without a stated subspecialty interest), applicants interested in PO&S were more likely to be female (P < 0.001). No significant difference was found in academic, research, or extracurricular variables based on subspeciality interest in PO&S. The same was true when applicants interested in PO&S were compared to those interested in competitive subspecialities (cornea, glaucoma, retina, or oculoplastics). CONCLUSIONS: Applicants interested in PO&S were observed to be as competitive as other applicants. Among students who expressed a fellowship interest, there was a high proportion interested in pediatrics. Recruitment efforts can be targeted toward encouraging medical students interested in pediatrics to apply into ophthalmology.
"Edutainment" videos for teaching pediatric ophthalmology and strabismus to medical students and residents: a pilot study.
Li J, Nguyen AM, Cabrera MT … +6 more , Soni A, Silverstein E, Kuo A, Gearinger M, Lee TC, Nallasamy S
J AAPOS · 2025 Jun · PMID 40349953 · Publisher ↗
PURPOSE: To determine whether videos designed to be educational and entertaining ("edutainment") may enhance trainees' clinical knowledge and interest in the field of pediatric ophthalmology and strabismus (PO&S). METHOD...
PURPOSE: To determine whether videos designed to be educational and entertaining ("edutainment") may enhance trainees' clinical knowledge and interest in the field of pediatric ophthalmology and strabismus (PO&S). METHODS: Medical students and residents from six US academic institutions watched edutainment videos related to PO&S within one week of starting their ophthalmology exposure. Questionnaires were administered to each participant before and after watching the videos to assess knowledge and experience with the videos. RESULTS: A total of 52 participants completed both the pre- and post-video questionnaires, of whom 44 (85%) were medical students; 8 (15%) were residents. For medical student respondents, the mean pre-video test score was 44.2% ± 12.3%; post-video, 74.1% ± 14.1%. For resident respondents, the mean pre-video test score was 75.8% ± 9.4%; post-video, 95.8% ± 5.0. All 52 respondents felt the videos enhanced their understanding of strabismus; 46 (89%) felt the videos helped them feel more comfortable with examining pediatric patients in ophthalmology clinic. Most respondents (45/52 [87%]) indicated that they were likely or very likely to review study material presented in video form compared to material presented in other formats, such as book chapters, journal articles, and lectures. Overall, 30 of 52 (58%) were more interested in the field of PO&S after watching the videos. CONCLUSIONS: Edutainment videos are an effective adjunct to traditional modes of teaching with the potential to enhance trainees' knowledge, confidence, and interest in the field of pediatric ophthalmology and strabismus.
Association between congenital nasolacrimal duct obstruction and otitis media.
Linaburg TJ, Binenbaum G, Buzi A … +4 more , Spiller A, Yu Y, Ying GS, Katowitz WR
J AAPOS · 2025 Jun · PMID 40349952 · Publisher ↗
BACKGROUND: Anatomic abnormalities causing congenital nasolacrimal duct obstruction (cNLDO) may be coincident with abnormalities predisposing to otitis media (OM). We evaluated the association between cNLDO and OM, consi...
BACKGROUND: Anatomic abnormalities causing congenital nasolacrimal duct obstruction (cNLDO) may be coincident with abnormalities predisposing to otitis media (OM). We evaluated the association between cNLDO and OM, considering surgical intervention as a marker of more severe disease. METHODS: We performed a retrospective cross-sectional study of children <5 years of age who received care from both a pediatrician and ophthalmologist at Children's Hospital of Philadelphia. Primary outcomes were associations between diagnoses of cNLDO by ophthalmologists and OM by pediatricians or otolaryngologists, and between cNLDO requiring surgical intervention and OM requiring surgical intervention. Subgroup analysis among children with OM was performed to assess for associations between cNLDO without surgery or cNLDO surgery and the need for myringotomy tubes (MT). RESULTS: Of 43,793 children studied, 1,571 (3.6%) had cNLDO, and 1,262 (2.9%) underwent cNLDO surgery. 16,947 (38.7%) had OM, and 4,433 (10.1%) underwent OM surgery with MT placement. cNLDO was significantly associated with OM (OR = 2.9; 95% CI, 2.6-3.2 [P < 0.001]). cNLDO surgery was significantly associated with MT placement (OR = 2.8; 95% CI, 2.4-3.2 [P < 0.001]). In children with OM, cNLDO requiring surgery was significantly associated with need for MT (OR = 2.0; 95% CI, 1.7-2.4 [P < 0.001]), but cNLDO not requiring surgery was not (OR = 0.9; 95% CI, 0.7-1.1). CONCLUSIONS: We found associations between cNLDO and OM, and between cNLDO surgery and MT placement both overall and specifically among children with OM, suggesting coincident anatomic abnormalities predisposing to both conditions. Pediatricians, pediatric otolaryngologists and ophthalmologists should be aware that for children with OM, history of cNLDO surgery may be a predictor of eventual need for MT.
Mortality of uveal melanoma in children and adolescents from 2004 to 2020.
Bade YM, Salman AR, Ahmed AK … +2 more , Ahmed SS, Dalvin LA
J AAPOS · 2025 Jun · PMID 40349951 · Full text
PURPOSE: To analyze epidemiological factors, tumor characteristics, and mortality rates in a cohort of pediatric patients with uveal melanoma (UM) from the National Cancer Database (NCDB). METHODS: In this retrospective...
PURPOSE: To analyze epidemiological factors, tumor characteristics, and mortality rates in a cohort of pediatric patients with uveal melanoma (UM) from the National Cancer Database (NCDB). METHODS: In this retrospective cohort study, patients ≤20 years of age in the NCDB diagnosed with UM were included. Patients were identified using ICD-10 and ICD-O-3 codes. Main outcome measures were demographics, clinical features, and overall survival. Mortality was assessed using Kaplan-Meier survival analysis and Cox logistic regression. Significance was defined as P < 0.05. RESULTS: Of 129 patients (68 females) included, mean age at diagnosis was 15.9 years. Most patients were White (91.5%), followed by Black (3.1%), and other races (5.4%). Tumors were primarily in the choroid (75.2%), followed by ciliary body (13.2%) or iris (7.0%). Kaplan Meier overall survival at 5-,10-, and 15-years was 93.6%, 80.3%, and 63.4%, respectively. Survival was worse with more advanced tumor T category (10-year survival 73.8% for cT1, 82.6% for cT2, 0% for cT4 [P = 0.022]) and American Joint Committee on Cancer stage (15-year survival 61.9% for stage I vs 45.5% for stage III [P < 0.001]). Cox logistic regression analysis identified older age at presentation (OR = 1.618, P = 0.036) and non-White race (OR = 21.39, P = 0.045) as significant predictors of mortality. CONCLUSIONS: In our study cohort, older age, non-White race, and advanced tumor stage at diagnosis were associated with increased mortality in children and adolescents with UM. Adolescents have a similar prognosis to adults, whereas children have more favorable outcomes.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe