J AAPOS [JOURNAL]
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200 papers
A rare case of infantile dacryoadenitis: a case report.
Zhang A, Choi CJ
J AAPOS · 2026 Apr · PMID 41720179 · Publisher ↗
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...
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.
A series of ruptured dermoid cysts in pediatric patients.
Livingston CA, Mudie LI, Yen MT … +1 more , Williams KJ
J AAPOS · 2026 Apr · PMID 41720178 · Publisher ↗
Ruptured dermoid cysts can often have atypical presentations and be challenging to manage. We report 3 cases of pediatric patients with ruptured dermoid cysts. Case 1 was a 16-year-old boy with an enlarging left superote...
Ruptured dermoid cysts can often have atypical presentations and be challenging to manage. We report 3 cases of pediatric patients with ruptured dermoid cysts. Case 1 was a 16-year-old boy with an enlarging left superotemporal orbital mass who presented with 2 days of acute inflammation. Computed tomography revealed a well-circumscribed lesion that was excised. Histopathology confirmed a ruptured dermoid cyst. Case 2 was a 4-year-old girl with a right superotemporal orbital mass that enlarged following trauma. Magnetic resonance imaging revealed a bilobed dermoid, and excision confirmed prior rupture. Case 3 was an 8-month-old girl with a left superotemporal dermoid cyst noted shortly after birth. By age 2 years, it was nonpalpable but later reappeared. Excision confirmed prior rupture. All patients achieved resolution following anterior orbitotomy with complete excision of the cyst wall, with no recurrences observed during follow-up. Given the variability in presentation, spontaneous rupture should remain on the differential diagnosis for periorbital lesions. Surgeons should maintain a high index of suspicion for occult cyst rupture, particularly when atypical lesions are located at the frontozygomatic suture.
Innovative nonsurgical treatment for central-peripheral rivalry-type diplopia.
Klaehn LD, Bodi TB, Kramer AM … +3 more , Iezzi R, Hodge DO, Bothun ED
J AAPOS · 2026 Apr · PMID 41713675 · Publisher ↗
PURPOSE: To evaluate whether a multifocal contact lens improves central-peripheral rivalry-type (CPR-type) diplopia in patients with epiretinal membrane and other maculopathies. METHODS: Seventeen consecutive adult patie...
PURPOSE: To evaluate whether a multifocal contact lens improves central-peripheral rivalry-type (CPR-type) diplopia in patients with epiretinal membrane and other maculopathies. METHODS: 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. RESULTS: 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; P ≤ 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; P = 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; P = 0.53). CONCLUSIONS: 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.
Corrigendum to Risk factors for capsular phimosis following congenital cataract extraction, Journal of American Association for Pediatric Ophthalmology and Strabismus, August 2025, Article 104279, Volume 29, Issue 4.
Al-Lozi AM, McFadyen J, Shue A … +1 more , Lambert SR
J AAPOS · 2026 Feb · PMID 41690901 · Publisher ↗
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Diffusely enlarged extraocular muscles in an infant with neurofibromatosis type 1.
Dogan Tosun S, Devine BC, Hanna N … +3 more , Wright E, Baccon J, Rossman I
J AAPOS · 2026 Feb · PMID 41655763 · Publisher ↗
Neurofibromatosis type 1 (NF1), a multisystemic autosomal dominant neurocutaneous disorder, presents with diverse ocular and systemic manifestations. It requires a multidisciplinary diagnostic and therapeutic approach. T...
Neurofibromatosis type 1 (NF1), a multisystemic autosomal dominant neurocutaneous disorder, presents with diverse ocular and systemic manifestations. It requires a multidisciplinary diagnostic and therapeutic approach. The ocular findings in NF1, such as Lisch nodules and optic pathway gliomas, are well studied and recognized as diagnostic criteria. We report the case of an infant with NF1 who was found on magnetic resonance imaging to have diffuse enlargement of the extraocular muscles.
Offline AI-assisted fundus imaging for preliminary screening of childhood glaucoma.
Senthil S, Rao DP, Bhandary S … +2 more , Krishnamurthy R, Negiloni K
J AAPOS · 2026 Feb · PMID 41654109 · Publisher ↗
PURPOSE: To evaluate the feasibility and performance of AI-assisted portable fundus photography in children with glaucoma. METHODS: This case series describes the use of smartphone-based fundus imaging with integrated of...
PURPOSE: To evaluate the feasibility and performance of AI-assisted portable fundus photography in children with glaucoma. METHODS: This case series describes the use of smartphone-based fundus imaging with integrated offline glaucoma artificial intelligence (AI) in children (≤18 years) with various types of glaucoma who were evaluated at a tertiary eye care center, and comparing AI-derived referral recommendations with presence or absence of structural optic nerve changes determined on clinical evaluation. RESULTS: AI-assisted fundus photography and clinical evaluation were completed for 21 children. For vertical cup:disk ratio, the 95% limits of agreement between AI image analysis and clinical assessment on Bland-Altman analysis were -0.15 to +0.23. The AI output recommended referral for 7 of 8 children who had structural optic nerve changes on clinical examination and did not recommend referral for any of the children without such optic nerve changes. CONCLUSIONS: AI-assisted smartphone-based fundus imaging may help identify cases of pediatric glaucoma exhibiting structural optic nerve changes.
Anterior megalophthalmos associated with CPAMD8 mutation: a case report.
Ninet L, Minot M, Morel V … +5 more , Dupessey F, Rendu I, Denis D, David T, Aziz A
J AAPOS · 2026 Feb · PMID 41654108 · Publisher ↗
A 5-year-old girl was referred for bilateral iridodonesis. Clinical evaluation revealed an enlarged horizontal corneal diameter, a markedly deep anterior chamber, diffuse iris transillumination, and bilateral posterior s...
A 5-year-old girl was referred for bilateral iridodonesis. Clinical evaluation revealed an enlarged horizontal corneal diameter, a markedly deep anterior chamber, diffuse iris transillumination, and bilateral posterior subcapsular cataracts. Gonioscopic examination demonstrated angle dysgenesis with posterior embryotoxon. Ultrasound biomicroscopy confirmed the bilateral anterior segment clinical abnormalities. Axial length was within normal limits. Intraocular pressure remained within normal limits, and there was no evidence of juvenile glaucoma. A diagnosis of anterior megalophthalmos was established. Genetic analysis revealed a pathogenic mutation in the CPAMD8 gene, which is known to be associated with anterior segment dysgenesis. This case supports the mutation of CPAMD8 as a genetic contributor to this rare developmental anomaly.
Acute lacrimal sac biopsy-confirmed Epstein-Barr virus dacryocystitis.
Yan L, Mo Y
J AAPOS · 2026 Feb · PMID 41644037 · Publisher ↗
Epstein-Barr virus (EBV) infection manifests with diverse clinical presentations. Primary EBV infection in children less than 6 years of age typically presents asymptomatically or with nonspecific upper respiratory sympt...
Epstein-Barr virus (EBV) infection manifests with diverse clinical presentations. Primary EBV infection in children less than 6 years of age typically presents asymptomatically or with nonspecific upper respiratory symptoms. EBV-associated acute dacryocystitis is exceptionally rare. We report the case of a 6-year-old boy with EBV-induced nasolacrimal duct obstruction and secondary acute dacryocystitis successfully managed via endoscopic dacryocystorhinostomy under general anesthesia.
The history and evolution of pediatric ophthalmology training: celebrating 50 years of the American Association for Pediatric Ophthalmology and Strabismus.
Donahue EKF, Baker JD, Donahue SP
J AAPOS · 2026 Feb · PMID 41644036 · Publisher ↗
In recognition of the 50th anniversary of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), we present the history and evolution of pediatric ophthalmology and strabismus training in the United...
In recognition of the 50th anniversary of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS), we present the history and evolution of pediatric ophthalmology and strabismus training in the United States and Canada. Using historical records, AAPOS charter member interviews, and a program director survey, we present the timeline of key events and our training history. Pioneers in Canada and the United States established the first pediatric ophthalmology preceptorships. These preceptorships and the programs founded by their trainees evolved into modern fellowship programs. Pediatric ophthalmology was the first ophthalmic subspecialty, and its training programs, meetings, and journal became the model for ophthalmologic subspecialty education. This structure has produced hundreds of pediatric ophthalmologists, whose shared research and training have led to improved visual outcomes for children worldwide. Understanding this history is important for current and future pediatric ophthalmologists.
The relationship between maternal cannabis use disorder diagnosis and the development of retinopathy of prematurity.
Tran MD, Baer RJ, Bandoli G … +4 more , Robbins SL, Granet D, Chambers CD, Rudell JC
J AAPOS · 2026 Feb · PMID 41638301 · Publisher ↗
PURPOSE: To compare the incidence of retinopathy of prematurity (ROP) among preterm infants born to mothers with and without a cannabis use disorder (CUD) diagnosis. METHODS: This retrospective cohort study used the UC S...
PURPOSE: To compare the incidence of retinopathy of prematurity (ROP) among preterm infants born to mothers with and without a cannabis use disorder (CUD) diagnosis. METHODS: This retrospective cohort study used the UC San Diego Study of Outcomes in Mothers and Infants (SOMI) population-based database and restricted the sample to infants born between 22 and <31 weeks' gestation, and/or having birth weight of <1500 g, who survived to the appropriate age for ROP screening. Infant ROP and maternal CUD during pregnancy were identified from International Classification of Diseases diagnostic codes from hospital discharge records. Adjusted relative risk (aRR) of ROP was calculated using log-linear regression, comparing mothers with and without CUD while controlling for demographic and clinical factors. RESULTS: Of the 997 infants born between 22 and <31 weeks to mothers with CUD, 32.1% developed ROP, compared with 33.3% of the 30,1113 infants born to mothers without CUD. Adjusting for maternal covariates, preterm infants born to mothers with CUD were not found to be at higher or lower risk of developing ROP than preterm infants born to mothers without CUD (aRR = 1.0; 95% CI, 0.9-1.1). CONCLUSIONS: In our study cohort, preterm infants born to mothers with CUD did not have an increased or decreased risk of developing ROP compared with those born to mothers without CUD.
Evaluation of retinal microvascular changes and laboratory characteristics in children with Wilson disease: an optical coherence tomography angiography study.
Eker S, Gumus M, Karakucuk Y … +3 more , Duyan SA, Gumustekin RK, Emiroglu HH
J AAPOS · 2026 Feb · PMID 41638300 · Publisher ↗
PURPOSE: To assess macular perfusion in a pediatric population with Wilson disease (WD) using optical coherence tomography angiography (OCTA). METHODS: Twenty-six patients diagnosed with WD by conventional laboratory tes...
PURPOSE: To assess macular perfusion in a pediatric population with Wilson disease (WD) using optical coherence tomography angiography (OCTA). METHODS: Twenty-six patients diagnosed with WD by conventional laboratory tests and liver biopsy in the pediatric gastroenterology department were enrolled. The superficial (VDs), deep (VDd) and choriocapillary (VDc) vascular densities of the patients were determined, Foveal avascular zones in the superficial (FAZs) and deep (FAZd) layers with central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were evaluated. OCTA measurements were compared with 35 age- and sex-matched healthy controls. RESULTS: Inferior sector values of VDs, VDd and VDc were significantly increased (P = 0.001, P = 0.002, P = 0.022, resp.). Mean FAZs and FAZd were significantly higher in WD cases (P = 0.001, P = 0.003). No statistical difference was detected in CMT and SFCT values (P > 0.05). Among patients with WD, the nasal sector values of the VDs, VDd and VDc were significantly correlated with 24-hour urinary copper excretion (r = 0.500, P = 0.009; r = 0.608, P = 0.001; r = 0.563, P = 0.003, resp.) and serum caeruloplasmin (r = 0.428, P = 0.029; r = 0.536, P = 0.005; and r = 0.548, P = 0.004, resp.). There was a statistically significant linear correlation between SFCT and hepatic copper level (r = 0.742 and P = 0.015). CONCLUSIONS: Alterations of the macular microcirculation were observed in children with WD. OCTA may offer a noninvasive method to evaluate patients with WD when other classic signs may not yet have been presented.
Strabismus surgery charges at ambulatory facilities across the United States.
Wu ZZ, Oatts JT, Hunter DG … +1 more , Oke I
J AAPOS · 2026 Feb · PMID 41628763 · Publisher ↗
PURPOSE: To identify factors associated with variation in strabismus surgery charges at hospital-owned facilities across the United States. METHODS: This cross-sectional study included all strabismus-related patient enco...
PURPOSE: To identify factors associated with variation in strabismus surgery charges at hospital-owned facilities across the United States. METHODS: This cross-sectional study included all strabismus-related patient encounters in the National Ambulatory Surgery Sample over a 5-year period (January 2016 to December 2020). The primary outcome was total charge per encounter. Multivariable linear regression was used to estimate the association of charge per encounter with patient, hospital, and regional characteristics, adjusting for procedure complexity and inflation. Sampling weights were used to generate nationally representative estimates and appropriate standard errors. RESULTS: We included 154,005 patient encounters. Most surgeries were performed on pediatric patients (70%) and at teaching facilities (92%). The median charge per encounter was $12,889 (IQR, $8,840 to $17,573). Compared with the Midwest, charges were higher in the Northeast by 20.0% (95% CI, 8.4%, 32.9%; P = 0.0004) and South by 15.9% (95% CI, 4.8%-28.1%; P = 0.004). Nonteaching hospitals had 35.0% (95% CI, 17.6%-55.0%; P < 0.0001) higher charges compared with teaching hospitals. Rural hospitals had 26.6% (95% CI, 19.4%-33.1%; P < 0.0001) lower charges compared to urban hospitals. Patients residing in ZIP codes within the lowest income quartile had on average 6.8% (95% CI, 1.8%-12.2%; P = 0.0079) higher charges than those in the highest income quartile. CONCLUSIONS: Our findings highlight substantial variation nationwide in charges for strabismus surgeries, raising important questions about how these differences may influence subspecialty geographic distribution of care and affect treatment access for patients with strabismus.
The role of enucleation in the development of nystagmus in children with retinoblastoma.
Olechowski A, Reed E, Naeem Z … +2 more , Sagoo MS, Reddy MA
J AAPOS · 2026 Feb · PMID 41628762 · Publisher ↗
BACKGROUND: Early enucleation has been linked to infantile nystagmus, or a pattern resembling fusion maldevelopment nystagmus syndrome (FMNS). We evaluated nystagmus characteristics and risk factors in a large cohort of...
BACKGROUND: Early enucleation has been linked to infantile nystagmus, or a pattern resembling fusion maldevelopment nystagmus syndrome (FMNS). We evaluated nystagmus characteristics and risk factors in a large cohort of children treated for retinoblastoma (RB). METHODS: The medical records of children who underwent unilateral enucleation for RB between 2009 and 2021 were retrospectively reviewed. Nystagmus type-FMNS or infantile nystagmus syndrome (INS)-was determined clinically. Potential risk factors included age at presentation, age at enucleation, visual acuity, laterality, and genetic status. RESULTS: Of 149 children who underwent enucleation of one eye (114 with unilateral, 35 with bilateral RB), 13 (9%) developed nystagmus over a mean follow-up of 67 months. Twelve showed INS and 1 had probable FMNS. All affected children carried a pathogenic RB1 variant, compared with 25% of those without nystagmus (P < 0.0001). Nystagmus onset occurred at a mean age of 3.75 months and was linked to earlier RB diagnosis (mean, 4.7 vs 29 months [P < 0.0001]), earlier enucleation (P < 0.0001), and poorer visual acuity (P < 0.0001). Of 11 infants enucleated before 6 months (median, 3 months), only 2 (18%) developed nystagmus despite healthy fellow foveas, with one showing FMNS features. CONCLUSIONS: In our study cohort, nystagmus occurred in a minority of children, predominantly at presentation rather than as a consequence of enucleation, and was strongly associated with RB1 mutation and early disease onset. These findings provide reassurance for families that unilateral enucleation in infancy rarely induces nystagmus when the fellow eye is healthy.
Minority representation in the 2024 American Association for Pediatric Ophthalmology and Strabismus (AAPOS) annual meeting program.
Josef JD, Bradfield YS, Greninger DA … +3 more , Chang TC, Diversity, Equity Inclusion Task Force members, Annual Program Committee members of the American Association of Pediatric Ophthalmology and Strabismus
J AAPOS · 2026 Feb · PMID 41628761 · Publisher ↗
PURPOSE: To determine the level of minority representation at the 2024 annual meeting of the American Association of Pediatric Ophthalmology and Strabismus (AAPOS). METHODS: The abstract submissions process for the 2024...
PURPOSE: To determine the level of minority representation at the 2024 annual meeting of the American Association of Pediatric Ophthalmology and Strabismus (AAPOS). METHODS: The abstract submissions process for the 2024 AAPOS annual meeting allowed self-reporting of authors' status as underrepresented in medicine (URiM). The choice "decline to answer" (DTA) was available for all questions. The different groups' submission outcomes (paper, poster, and workshop) were compared. URiM was defined as having one or more of the following identities: Black or African American; Hispanic or Latino; American Indian or Alaska Native; Native Hawaiian or other Pacific Islander; and lesbian, gay, bisexual, transgender, or queer. RESULTS: In research abstracts, 17% of all authors and 13.7% of presenting authors identified as URiM (16% and 17% chose DTA, resp.). There were no significant differences in the proportion of abstracts accepted as a paper or poster presentation between URiM and non-URiM authors (P > 0.7 for all comparisons). Female presenting authors were more likely to have an accepted abstract than males (81.6% vs 66.4% [P = 0.0015]). Subgroup analysis showed no differences between URiM and non-URiM in paper presentations. In workshop abstracts, 39.6% of panelists and 10.4% of organizers identified as URiM, respectively. There were no significant differences in workshop abstract acceptance rates between URiM and non-URiM presenting authors (P > 0.1 for all comparisons). CONCLUSIONS: The current AAPOS approach toward meeting representation, which includes masked evaluation of abstracts for presentation, appears to be equitable toward URiM presenters.
Sociodemographic factors and pediatric eye examinations: a population-based analysis.
Mihalache A, Huang RS, Zajner C … +6 more , Popovic MM, Cheung CSY, Chong S, Kertes PJ, Muni RH, Kohly RP
J AAPOS · 2026 Feb · PMID 41628760 · Publisher ↗
PURPOSE: To explore associations between sociodemographic determinants and whether children received an eye examination within the previous year in the United States. METHODS: Using data from the 2022 National Health Int...
PURPOSE: To explore associations between sociodemographic determinants and whether children received an eye examination within the previous year in the United States. METHODS: Using data from the 2022 National Health Interview Survey, this population-based study included participants <18 years of age for whom data were available to determine whether they had received an eye examination within the previous year. Multivariable logistic regression analyses were performed to explore associations between sociodemographic variables and caregiver-reported eye examinations. RESULTS: Of the 7,365 children included (mean age, 8.8 ± 6.3 years), 2,912 (39.5%) underwent an eye examination. In a multivariable model, children in all age groups older than 4 years (OR ranging from 4.16 to 6.91) and children of parents with a higher educational attainment (OR ranging from 1.44 to 1.52) were more likely to have had an eye examination compared with the youngest age group and lowest educational attainment group, respectively. Lack of health insurance coverage (OR = 0.58; 95% CI, 0.40-0.83; P = 0.003) and forgoing medical care due to cost (OR = 0.42; 95% CI, 0.21-0.87; P = 0.019) were both associated with lower odds of having had an eye examination. However, children living with a parent who was neither married nor living with a partner had higher odds of receiving an eye examination than those whose caregivers were married or living with a partner (OR = 1.27; 95% CI, 1.07-1.51; P = 0.006). CONCLUSIONS: Having undergone a pediatric eye examination was associated with age, parental education, parental relationship status, insurance coverage, and the ability to afford medical care. Inequities prevail across the United States with respect to pediatric eye examination access, and ongoing public health initiatives are needed to proactively advocate for equitable access to eye care.
Clinical, demographic, and socioeconomic factors associated with outpatient retinopathy of prematurity follow-up.
Liu EJ, Freedman SF, Stinnett SS … +1 more , Prakalapakorn SG
J AAPOS · 2026 Feb · PMID 41628759 · Publisher ↗
BACKGROUND: Following hospital discharge, infants needing continued retinopathy of prematurity (ROP) examinations are vulnerable to being lost to follow-up. Social determinants of health (SDOH) may further impede access...
BACKGROUND: Following hospital discharge, infants needing continued retinopathy of prematurity (ROP) examinations are vulnerable to being lost to follow-up. Social determinants of health (SDOH) may further impede access to outpatient follow-up. The purpose of this study was to evaluate the association of clinical, demographic, and socioeconomic factors with timely first outpatient ROP follow-up. METHODS: This retrospective study reviewed all infants examined for ROP inpatient between September 17, 2013, and December 31, 2023. We included only infants requiring continued outpatient ROP examination(s) at our institution. The primary outcome was "on-time" follow-up to the first outpatient visit, defined as returning within 3 days after the recommended follow-up date. Multivariable analysis was performed. RESULTS: Of 1,424 infants examined for ROP, 532 (37.4%) required outpatient ROP examination(s) (mean birth weight, 925 g; mean gestational age, 26.9 weeks, mean postmenstrual age at last inpatient examination, 41.5 weeks). Although 525 (98.7%) infants followed up outpatient, only 432 (81.2%) had "on-time" follow-up. On multivariable analysis, not following up on-time increased with recommended follow-up >14 days versus <7 days (OR = 3.9, P = 0.004), English-language preference (OR = 3.6, P = 0.04), no treatment before hospital discharge (OR = 2.4, P = 0.01), public (ie, Medicaid) versus private insurance (OR = 1.9, P = 0.02), and higher area deprivation index (OR = 1.1, P = 0.003). CONCLUSIONS: Higher risk of delayed/missed first outpatient ROP follow-up was associated with less severe disease (ie, longer recommended follow-up intervals and no ROP treatment before discharge) and SDOH (ie, having public insurance and residence in socioeconomically disadvantaged neighborhoods). Elucidating clinical, demographic, and socioeconomic factors associated with outpatient ROP follow-up nonadherence may help inform targeted efforts for improvement.
Hispanic ethnicity associated with worse pediatric blepharokeratoconjunctivitis at a tertiary children's hospital in the United States.
Lai JM, Patnaik JL, Wise R … +2 more , McCourt EA, Edwards Mayhew RG
J AAPOS · 2026 Feb · PMID 41628758 · Publisher ↗
PURPOSE: To compare the severity of corneal disease and complications associated with pediatric blepharokeratoconjunctivitis (PBKC) as well as barriers to care in Hispanic and non-Hispanic children. METHODS: The medical...
PURPOSE: To compare the severity of corneal disease and complications associated with pediatric blepharokeratoconjunctivitis (PBKC) as well as barriers to care in Hispanic and non-Hispanic children. METHODS: The medical records of all children <18 years of age who met broadened PBKC spectrum criteria at Children's Hospital Colorado between 2019 and 2024 were reviewed retrospectively. Patients self-reported as Hispanic or non-Hispanic ethnicity. Data were collected on patient demographics, corneal disease severity, and adverse outcomes associated with PBKC at the time of diagnosis and worst stage during their care. RESULTS: A total of 405 records were reviewed. Of these, 175 children with PBKC were included, with 116 (66.3%) identifying as Hispanic, 52 (29.7%) as non-Hispanic, and 7 (4.0%) with unknown or unreported ethnicity. Hispanic children were more likely to have moderate and severe corneal disease at their worst stage than non-Hispanic children (P < 0.001). A higher proportion of Hispanic children required interpreter services (P < 0.001), lacked private insurance (P < 0.001), and resided in areas with lower median incomes (P = 0.004) and overall childhood opportunity indices (P < 0.001). Multivariable analysis showed moderate and severe corneal disease at the worst stage was associated only with Hispanic ethnicity (OR = 3.31; 95% CI, 1.53-7.14; P = 0.002). CONCLUSIONS: In our patient cohort, Hispanic children are more frequently affected by PBKC, with worse corneal disease, in addition to, and independent of, experiencing differing social determinants of health compared with non-Hispanic children.
Ocular conditions associated with parental concerns regarding childhood development and worse quality of life among multiethnic preschool children.
Xu J, Zafar A, Torres M … +2 more , Varma R, Jiang X
J AAPOS · 2026 Feb · PMID 41621778 · Full text
PURPOSE: To assess the associations of specific ocular conditions on parental concerns for child development and quality of life in multiethnic preschool-age children. METHODS: We conducted a cross-sectional analysis usi...
PURPOSE: To assess the associations of specific ocular conditions on parental concerns for child development and quality of life in multiethnic preschool-age children. METHODS: We conducted a cross-sectional analysis using parental interview and comprehensive eye examination data from the Multi-Ethnic Pediatric Eye Disease Study, a population-based study of children aged 6-72 months. Parental concerns were assessed using the Parents' Evaluation of Developmental Status Screening Instrument; quality of life, via the Pediatric Quality of Life Inventory. Multivariable regression analyses were performed. RESULTS: Data were available for 8,265 children. Parental concerns were reported for 16.0%. Strabismus was associated with parental concerns even after adjusting for covariates (P < 0.001). Astigmatism was associated with parental concerns among children aged 36-72 months (P = 0.018). In this group, odds ratios for parental concerns were 1.33 (95% CI, 1.02-1.72) for astigmatism of 1.50 to <3.0 D, 1.39 (0.85-2.25) for ≥3.0 D, and 1.65 (1.12-2.41) for strabismus. Hyperopia, myopia, anisometropia, or amblyopia showed no association. Astigmatism of 3.0 D or greater and strabismus were also associated with a history of physician-diagnosed developmental delay (OR [95% CI] = 3.97 [1.53-10.28] and 6.58 [3.52-12.32], resp.) and with lower physical health/emotional function scores (2.3 ± 0.8 and 3.5 ± 1.3 points lower for astigmatism ≥3.0 D vs <1.5 D, and 2.0 ± 0.6 and 2.0 ± 0.9 points lower for strabismus vs no strabismus; all Ps ≤ 0.031). CONCLUSIONS: Both astigmatism and strabismus correlated with greater parental concerns about development and worse quality of life in preschoolers.
Preappointment dilation drops for retinopathy of prematurity examination visits: an equitable intervention to reduce clinic time regardless of insurance status.
Rocks MC, Heath D, Moyer L … +7 more , Bansal P, Bhatia S, Movaghar M, Moll A, O'Halloran H, Carter C, Hennein L
J AAPOS · 2026 Feb · PMID 41621777 · Publisher ↗
PURPOSE: To evaluate the results of a quality improvement study designed to enhance retinopathy of prematurity (ROP) clinic workflow at a large academic children's hospital by having care givers predilate the eyes of chi...
PURPOSE: To evaluate the results of a quality improvement study designed to enhance retinopathy of prematurity (ROP) clinic workflow at a large academic children's hospital by having care givers predilate the eyes of children prior to their screening. METHODS: The study was conducted prospectively from February 1, 2023, to May 31, 2024. Predilation drops were prescribed for caregivers to administer 90-minutes prior to ROP appointments. A discounted mail order pharmacy option was made available to ensure access to dilation drops at a maximum of $40 regardless of insurance status. Primary outcome was median clinic time (check-in to check-out) for ROP patients, with additional analysis of adverse events and clinic time variations by insurance type. RESULTS: A total of 918 ROP examination visits were included. All patients who underwent ROP evaluation at the clinic during the study period were eligible; no exclusion criteria were applied. The median clinic time decreased from 81.7 minutes to 61.9 minutes, saving 19.8 minutes per visit (P < 0.001). Predilation rates increased to 52% of patients by the study's conclusion. There were no significant differences in time savings across insurance types (P = 0.536), and no adverse events were reported. CONCLUSIONS: In this study, integrating predilation drops into our workflow reduced clinic time for ROP screening visits. The intervention was equitable across diverse patient populations, including those with differing insurance and socioeconomic statuses, and no adverse events were recorded.
Self-reported physical activity in school age children with amblyopia.
Koritala BA, Jost RM, Cheng-Patel C … +4 more , Beauchamp C, Giridhar P, Luu B, Birch EE
J AAPOS · 2026 Feb · PMID 41621776 · Full text
BACKGROUND: Residual amblyopia is associated with difficulties with eye-hand coordination, aiming and catching, balance, and gait. Whether these motor skill difficulties have an impact on physical activity and health is...
BACKGROUND: Residual amblyopia is associated with difficulties with eye-hand coordination, aiming and catching, balance, and gait. Whether these motor skill difficulties have an impact on physical activity and health is poorly understood. METHODS: In this cross-sectional study, 132 children 8-13 years of age completed the self-report Physical Activity Questionnaire for Children: 59 amblyopic children, 29 children with strabismus or anisometropia who were never amblyopic or were no longer amblyopic after treatment (nonamblyopic), and 44 control children. Subsets of children in each group also completed BMI measurement, a self-perception of athletic competence questionnaire, motor skills assessment, and the PedEyeQ Functional Vision domain questionnaire. A subset of parents rated their child's physical activity as sedentary, light, moderate, or very active. RESULTS: Overall, 63% were non-Hispanic White and 54% were female, with a mean age of 9.9 ± 1.7 years. Of the 59 amblyopic children, 46% had anisometropia, 31% had been treated for strabismus, and 24% had both. Neither a significant difference in overall physical activity nor BMI was identified among children with amblyopia, nonamblyopic children, and controls (F = 1.12, P = 0.33; F = 0.43, P = 0.65, resp.). Responses from both children and their parents were consistent with light to moderate levels of physical activity in all three groups. Children with amblyopia had deficits in motor skills, self-perception of athletic competence, and functional vision relative to controls (F = 11.51, P < 0.0001; F = 3.47, P = 0.04; F = 20.20, P < 0.0001, resp.). CONCLUSIONS: Despite significant impairments in motor skills, and differences in athletic self-perception and functional vision, children with amblyopia maintain overall physical activity levels and BMI comparable to their control peers.
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