We describe the case of a 6-year-old boy who presented with a right eye bruise after hitting the corner of a chair. Although slit-lamp microscopy revealed only conjunctival lacerations, B-scan ultrasound and computed tom...We describe the case of a 6-year-old boy who presented with a right eye bruise after hitting the corner of a chair. Although slit-lamp microscopy revealed only conjunctival lacerations, B-scan ultrasound and computed tomography of the right eye orbital region showed high-intensity reflections and a high-density area, respectively. Suspecting an intraorbital foreign body, we reinterviewed the patient, who admitted to falling while holding a green-colored pencil. The patient was taken for surgery under general anesthesia, and a yellow, liquified muddy foreign body was located under the nasolateral Tenon's capsule, adjacent to the medial rectus muscle, and removed. Eyelid swelling, conjunctival chemosis, and severe pain were noted postoperatively. Intravenous cefozopran hydrochloride (900 mg/day) and oral steroids (20 mg/day) were administered for inflammation. Colored pencils containing kaolin can cause severe inflammation, necessitating urgent surgical removal.
BACKGROUND: Synthetic models for strabismus surgery have the potential to enhance training without the complexities of biologic material. Models described to date are relatively large and costly, potentially limiting acc...BACKGROUND: Synthetic models for strabismus surgery have the potential to enhance training without the complexities of biologic material. Models described to date are relatively large and costly, potentially limiting access. We set out to design and validate a handheld surgical strabismus trainer. METHODS: Utilizing a silicone mold and 3D printer, we developed a 6.25 × 4.5 × 2.5 cm model, the "Pocket Strabismus Surgical Skills Trainer," optimized for practicing essential steps of strabismus surgery, including securing the muscle, scleral passes, and conjunctival closure. The materials required to print each model cost less than US $30. We surveyed participants across three ophthalmology training programs who participated in two workshops. Perceptions were assessed with an anonymous Likert scale questionnaire. RESULTS: Thirty trainees and 6 faculty completed the survey. All participants reported that the pocket simulator had easy open/close, setup, and storage (P = 0.003). The appearance of the eyeball, sclera, and rectus muscles was felt to be sufficiently reproduced among the majority of participants (97%, 86%, and 81%, resp. [P = 0.001]). Most participants agreed that the sclera/extraocular muscles felt realistic (77%/81% [P = 0.005]) and modeled real practice (92%/100% [P = 0.002]). CONCLUSIONS: Trainee and faculty perceptions of the Pocket Strabismus Surgical Skills Trainer reflected ease of use, realistic critical ocular tissue structures, and a design that facilitates practice of key surgical steps. These results support our goal to provide a low-cost model that will broaden hands-on strabismus surgical training.
Of 894,375 Israeli adolescents undergoing standardized medical and ocular assessments in our nationwide cross-sectional study, 2,622 (0.3%) had autism spectrum disorder (ASD). Adolescents with ASD had significantly highe...Of 894,375 Israeli adolescents undergoing standardized medical and ocular assessments in our nationwide cross-sectional study, 2,622 (0.3%) had autism spectrum disorder (ASD). Adolescents with ASD had significantly higher adjusted odds of both myopia and astigmatism compared with peers who did not have ASD. The relative odds of refractive error in ASD increased with both myopia severity and astigmatism cylinder power. Associations were consistent across all astigmatism axis orientations, most notably with-the-rule. These findings suggest that early and routine vision screening may be beneficial in identifying and addressing refractive errors among youth with ASD.
We report a rare case of restrictive strabismus in a pediatric patient who was initially misdiagnosed with Duane retraction syndrome (DRS) because she had large-angle exotropia, restricted adduction, globe retraction, na...We report a rare case of restrictive strabismus in a pediatric patient who was initially misdiagnosed with Duane retraction syndrome (DRS) because she had large-angle exotropia, restricted adduction, globe retraction, narrowing of the palpebral fissure, and downshoot on attempted adduction. Notably, the parents first observed strabismus at 12 months of age, with photographs taken before 6 months of age revealing no ocular misalignment. Despite the absence of typical inflammatory signs, the temporal discrepancy, characterized by delayed onset inconsistent with congenital DRS, prompted further investigation. Subsequent magnetic resonance imaging demonstrated no typical appearances of DRS or other intracranial abnormalities but revealed fusiform enlargement of the lateral rectus muscle, raising suspicion of orbital myositis. Surgical exploration confirmed fibrosis of the lateral rectus muscle. Strabismus surgery involving recession of the fibrotic lateral rectus muscle resulted in improved alignment and motility.
Biallellic CLDN19 pathogenic variants cause syndromic macular atrophy or pseudocoloboma (familial hypomagnesemia with hypercalciuria and nephrocalcinosis). Macular atrophic lesions in children with CLDN19-related disease...Biallellic CLDN19 pathogenic variants cause syndromic macular atrophy or pseudocoloboma (familial hypomagnesemia with hypercalciuria and nephrocalcinosis). Macular atrophic lesions in children with CLDN19-related disease have been reported as stable over follow-up, although it remains unclear whether they are congenital or acquired (developmental). This report highlights the case of an infant with nephropathy and high myopia for whom acquired macular atrophy redirected genetic studies and led to the diagnosis of CLDN19-related disease.
We present the case of a 15-year-old boy on long-term azathioprine treatment for Crohn's disease who developed bilateral pterygia. He had no family history of pterygium formation, and he lived in a northern English town...We present the case of a 15-year-old boy on long-term azathioprine treatment for Crohn's disease who developed bilateral pterygia. He had no family history of pterygium formation, and he lived in a northern English town with a low ultraviolet (UV) index. This case highlights a possible association between azathioprine intake and development of pterygium, possibly attributable to UVA photosensitization.
BACKGROUND: Gender representation in academic pediatric ophthalmology has shifted significantly in recent decades, with increasing female participation. This study examines academic rank, leadership roles, and research p...BACKGROUND: Gender representation in academic pediatric ophthalmology has shifted significantly in recent decades, with increasing female participation. This study examines academic rank, leadership roles, and research productivity as a function of gender. METHODS: This cross-sectional study analyzed publicly available data from 126 US academic ophthalmology programs listed in the Fellowship and Residency Electronic Interactive Database (FREIDA) during August 2024. Data collected from institutional websites identified 451 fellowship-trained pediatric ophthalmologists. Variables included gender, fellowship graduation year, academic rank, leadership roles (eg, department chair, fellowship director, program director), and research productivity metrics (publications, citations, h-index). Statistical comparisons used Pearson's χ test, the Fisher exact test, and Mann-Whitney U or t tests, where appropriate, with significance defined as P < 0.05. RESULTS: Women now account for 55.9% (252/451) of academic pediatric ophthalmologists. Among those who completed fellowships before 2000, males constitute a larger proportion than females (69.7% vs 30.3%); since 2000, females comprise a greater share of fellowship graduates (65.3% vs 34.7% [P < 0.01]). Men more frequently serve as full professors (40.9% vs 18.0%, P <0.01]) and department chairs (6.5% vs 2.0% [P = 0.02]; women, more often as assistant professors (54.5% vs 40.1% [P = 0.01]) and program directors (3.6% vs 0.5% [P = 0.03]). Research productivity and academic rank are similar between genders in post-2000 graduates. CONCLUSIONS: Gender disparities persist in senior roles, but recent cohorts of currently practicing faculty demonstrate similar levels of academic rank and research productivity. Women now account for 55.9% of academic pediatric ophthalmologists and 65.3% of post-2000 graduates.
BACKGROUND: The current shortage of pediatric ophthalmologists leaves many children without access to timely care. Almost half of pediatric ophthalmology fellowship positions go unfilled annually. The purpose of this stu...BACKGROUND: The current shortage of pediatric ophthalmologists leaves many children without access to timely care. Almost half of pediatric ophthalmology fellowship positions go unfilled annually. The purpose of this study was to investigate residency factors associated with pursuit of a fellowship in pediatric ophthalmology. METHODS: An online questionnaire designed to elicit information about residency program characteristics, exposure to pediatric ophthalmology, and resident pursuit of fellowships between 2018 and 2023 was sent to all United States ophthalmology residency program directors. Univariate logistic regression models were used to assess the factors associated with programs having at least one resident pursue a pediatric ophthalmology fellowship. RESULTS: The survey response rate was 54% (66/121 eligible programs). More than half (56%) reported residents' initial exposure to pediatric ophthalmology in the PGY-2 year. Mean (with standard deviation) total days of resident exposure to pediatric ophthalmology was 66.32 ± 27.90. Forty programs (61%) graduated at least 1 resident who pursued a pediatric ophthalmology fellowship during the study period. In univariate logistic regression, larger residency program size, higher number of pediatric ophthalmologists on core faculty, and presence of a pediatric ophthalmology fellowship were all significantly associated with residents pursuing a pediatric ophthalmology fellowship (all P < 0.05). CONCLUSIONS: Over half of programs responding to the survey had a resident pursue pediatric ophthalmology fellowship in the last 5 years. Relational factors, such as pediatric ophthalmology-specific mentorship, were the most important predictors of pediatric ophthalmology fellowship pursuit. Increasing access to faculty, connecting residents to fellows, and organizing mentorship programs could be effective strategies to foster greater interest in pediatric ophthalmology as a career.
MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the RB1 gene. We present the case of a 3-month-...MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the RB1 gene. We present the case of a 3-month-old girl with unilateral cavitary retinoblastoma that initially responded well to intra-arterial chemotherapy but later recurred. After enucleation, the tumor was found to exhibit MYCN amplification, but there were no RB1 variants. Retinoblastoma tumors with MYCN amplification are known to carry a poor prognosis and often require enucleation. On the contrary, cavitary retinoblastomas tend to be well differentiated, with favorable prognosis. To our knowledge, this is the first report of a MYCN-amplified tumor presenting as cavitary retinoblastoma.
IFT140-related recessive ciliopathy is associated with variants in the IFT140 gene and encompasses a syndromic phenotype or a purely ocular phenotype. However, the associations of the specific variants in IFT140 with the...IFT140-related recessive ciliopathy is associated with variants in the IFT140 gene and encompasses a syndromic phenotype or a purely ocular phenotype. However, the associations of the specific variants in IFT140 with the resulting syndromic or ocular phenotype have not been systematically documented. Additionally, it is not known whether the ocular findings differ between the two phenotypes. Our systematic review of existing literature has identified a total of 93 individuals with disease-causing variants of IFT140; most individuals had ophthalmic manifestations. Features of retinal dystrophy were the most common findings in both phenotypes. Cataracts and lens opacities are more common in ocular-only IFT140-related recessive ciliopathy, whereas syndromic IFT140-related recessive ciliopathy has more instances of strabismus.
PURPOSE: To estimate the distribution of pediatric ophthalmologists (POs) and retina specialists (RSs) in the United States and assess capacity for retinopathy of prematurity (ROP) care based on neonatal intensive care u...PURPOSE: To estimate the distribution of pediatric ophthalmologists (POs) and retina specialists (RSs) in the United States and assess capacity for retinopathy of prematurity (ROP) care based on neonatal intensive care unit (NICU) bed availability and ROP prevalence. METHODS: We conducted a cross-sectional study using data from the American Association for Pediatric Ophthalmology and Strabismus, the American Academy of Ophthalmology, and the American Society of Retina Specialists databases to identify POs and RSs. NICU bed capacity was assessed using the Neonatology Solutions Database, focusing on level 3 and level 4 NICUs. ROP case numbers were derived from the 2019 IRIS Registry data summary in the Vision and Eye Health Surveillance System. Provider-to-patient ratios, NICU beds-to-provider ratios, and a forecast model for provider workload were calculated using state- and region-specific ROP data. RESULTS: We identified 3,983 providers (1,072 POs and 2,911 RSs), with the highest provider concentration in the South (n = 1,430). The South also had the highest number of ROP cases (71,520 of 177,940 estimated cases nationally) and case per provider ratio (50.01) compared with the Midwest (45.65), West (42.32), and Northeast (37.41). Of 836 total NICUs, 709 were level 3 and 127 were level 4, with an adjusted bed capacity of 25,708 for ROP screening and treatment. States with the highest bed-to-provider ratios were Mississippi (19.35), North Dakota (18.67), and Arkansas (14.70). Across all regions, reducing the assumed percentage of providers offering ROP care led to substantial increases in patient load per provider, with the South experiencing the greatest projected shortage. CONCLUSIONS: Significant regional disparities exist in ROP care, particularly in high-burden areas such as the South. Strategic workforce interventions are needed to ensure equitable access to ROP screening and treatment services nationwide.
BACKGROUND: Visual axis opacities are one of the most common complications following infantile cataract surgery. To date, most studies have focused on lens reproliferation and pupillary membranes rather than capsular phi...BACKGROUND: Visual axis opacities are one of the most common complications following infantile cataract surgery. To date, most studies have focused on lens reproliferation and pupillary membranes rather than capsular phimosis. We evaluated risk factors for capsular phimosis after lensectomies in infants. METHODS: A retrospective chart and video review of patients seen at a single institution over a period of 4 years was performed. Exclusion criteria were follow-up of <7 months and poor video quality. Two independent examiners, masked to patient outcomes, calculated capsulotomy diameters from video stills. To analyze risk factors for capsular phimosis, the χ test was used for categorical variables; the independent t test for continuous variables. For bilateral cases, one eye was randomly included in capsulotomy analysis. RESULTS: A total of 20 eyes of 12 patients, aged 1.7 months (IQR, 1.25; range, 0.6-3.2) at time of surgery, were reviewed. Median follow-up was 1.7 years (IQR, 2.39; range, 0.5-3.9). Capsular phimosis developed in 7 eyes (35%) and required surgical intervention in 5 eyes (25%) a median of 2.3 months (IQR 1.49; range, 1.2-5.1) after primary surgery. Male sex (P = 0.03) and smaller anterior horizontal (4.31 vs 5.78 mm [P = 0.0039]), anterior vertical (4.67 vs 5.59 [P = 0.0131]), and posterior vertical (4.10 vs 5.08 mm [P = 0.00074]) capsulotomy diameters increased risk of phimosis. CONCLUSIONS: In our study cohort, capsular phimosis was a common complication following a lensectomy in infants. Smaller anterior and posterior capsulotomy diameters increase risk of capsular phimosis.
BACKGROUND: Vitamin A deficiency (VAD) is increasingly recognized in high-income countries, driven by conditions such as gastrointestinal disorders, restrictive diets, and avoidant/restrictive food intake disorder (ARFID...BACKGROUND: Vitamin A deficiency (VAD) is increasingly recognized in high-income countries, driven by conditions such as gastrointestinal disorders, restrictive diets, and avoidant/restrictive food intake disorder (ARFID). ARFID, particularly prevalent in individuals with autism spectrum disorder (ASD), can lead to severe nutrient deficiencies with systemic and ophthalmological consequences. We present a series of pediatric patients with ASD and ARFID who developed severe, progressive vision loss due to optic canal hyperostosis and compressive optic neuropathy associated with VAD. METHODS: Patients treated at a single tertiary care center from January 2024 to December 2024 who were diagnosed with VAD, optic neuropathy, and hyperostosis of the optic canals were identified through a retrospective review of medical records. Data collected included full orthoptic and ophthalmological evaluation, electrodiagnostic testing, and fundus imaging where possible. Serological and neuroradiological investigations were included. RESULTS: Five patients were identified. All presented with bilateral or unilateral visual impairment, optic atrophy, and restricted diets dominated by carbohydrate-rich, low-nutrient foods. Investigations revealed VAD alongside other nutritional deficiencies. Imaging demonstrated diffuse skull thickening, optic canal narrowing, and compression of intracanalicular optic nerve segments. Electrophysiological findings suggested optic nerve dysfunction rather than primary retinal involvement. Despite vitamin A supplementation, vision did not recover in most cases, emphasizing the irreversible nature of prolonged optic nerve compression. Surgical decompression was attempted in one case, without visual improvement. CONCLUSIONS: This series underscores the importance of early identification and management of ARFID-related nutritional deficiencies to prevent irreversible complications. Further research is needed to explore optimal management strategies, including whether there is any role for optic canal decompression in these patients.
Intellectual developmental disorder with dysmorphic facies and ptosis (IDDDFP) is a genetic disorder caused by variants in BRPF1. We report the case of a 2-year-old girl who presented with drooping of the left upper lid...Intellectual developmental disorder with dysmorphic facies and ptosis (IDDDFP) is a genetic disorder caused by variants in BRPF1. We report the case of a 2-year-old girl who presented with drooping of the left upper lid since birth and who was ultimately diagnosed with IDDDFP. Genetic testing identified a maternally inherited stop-loss variant of the BRPF1 gene. The literature on reported cases of BRPF1 is also reviewed.
PURPOSE: To examine strabismus patterns and surgical outcomes in patients with teprotumumab-treated thyroid eye disease (TED). METHODS: The medical records of TED patients with strabismus who were treated with teprotumum...PURPOSE: To examine strabismus patterns and surgical outcomes in patients with teprotumumab-treated thyroid eye disease (TED). METHODS: The medical records of TED patients with strabismus who were treated with teprotumumab from 2014 to 2023 were reviewed retrospectively. Strabismus surgery sensorimotor outcomes in this cohort were also compared with those of a prior study of teprotumumab-untreated patients at the same institution. RESULTS: A total of 28 teprotumumab-treated patients (mean age, 62.3 years; 19 females [68%]) were identified and included. No significant difference in the mean magnitude of horizontal strabismus at distance was observed in 9 patients who had sensorimotor measurements pre- and post-teprotumumab (30.4 ± 26.0 vs 23.1 ± 30.9 [P = 0.375]); however, vertical deviations significantly decreased after treatment (17.2 ± 15.9 vs 3.7 ± 13.6 [P = 0.023]). Post-teprotumumab, all patients (100%) had persistent diplopia; this was treated with prisms in 12 patients (43%), strabismus surgery in 11 (39%), and prisms and surgery in 4 (14%). One patient was not treated. In the surgical subgroup (n = 15), the mean interval from the last teprotumumab treatment to surgery was 16 ± 6.8 months (range, 3-30). The mean preoperative deviations at distance were 17.0 ± 10.8 vertically and 21.3 ± 20.6 horizontally. Postoperatively, mean deviations were -2.0 ± 14.7 vertically and 3.5 ± 8.2 horizontally. After the first strabismus surgery, 73% of patients were diplopia-free, compared with 58% in our previously reported cohort of teprotumumab-untreated patients (P = 0.26), and 67% achieved motor success, compared with 69% in our previous cohort. CONCLUSIONS: Teprotumumab did not affect the degree of horizontal strabismus, but the magnitude of vertical deviations was reduced following treatment. The present study achieved a high rate of sensory success and similar rate of motor success in teprotumumab-treated patients compared with teprotumumab-untreated patients from a 2020 study conducted at the same institution.
PURPOSE: To describe the ophthalmic manifestations and visual outcomes of pediatric systemic lupus erythematosus (SLE) and its commonly used medications, including hydroxychloroquine and corticosteroids. METHODS: The cha...PURPOSE: To describe the ophthalmic manifestations and visual outcomes of pediatric systemic lupus erythematosus (SLE) and its commonly used medications, including hydroxychloroquine and corticosteroids. METHODS: The charts of all pediatric patients (<21 years of age) treated for SLE between December 2000 and May 2024 at a quaternary children's hospital were retrospectively reviewed. Patient demographics, rheumatology and ophthalmology examinations, and treatments were collected. Outcomes included ophthalmic manifestations, visual acuity, and hydroxychloroquine toxicity screening results. RESULTS: A total of 180 patients were included (87% female). Mean age at presentation was 13.4 ± 3.4 years (range, 3-20), and mean age of SLE diagnosis was 13.5 ± 3.6 years. Of these patients, 84 were evaluated by ophthalmology, and 33 (39%) had one or more ocular manifestations related to SLE or SLE medications, most commonly retinal vascular changes or lesions (n = 8), papilledema (n = 6), hydroxychloroquine toxicity (n = 6), cataracts (n = 5), and dry eye (n = 5). Twenty-six patients had ocular manifestation(s) of SLE and long-term ophthalmology follow-up: initial best-corrected visual acuity of the worse-seeing eye was logMAR 0.05 ± 0.13; final, logMAR 0.01 ± 0.09. Of the remaining patients, 92 not evaluated by our ophthalmology department were using hydroxychloroquine, of whom 29 (32%) had no mention of undergoing hydroxychloroquine toxicity screening at other institutions. CONCLUSIONS: There is a substantial burden of ophthalmic disease in pediatric SLE, albeit with good visual outcomes. Pediatric patients should receive prompt baseline ophthalmic examination at SLE diagnosis and routine screening thereafter.
A 4-year-old girl developed fat atrophy in her forehead 1 month after a single intratrochlear triamcinolone injection. The fat atrophy resolved spontaneously within 1 year. Pediatric ophthalmologists should be aware that...A 4-year-old girl developed fat atrophy in her forehead 1 month after a single intratrochlear triamcinolone injection. The fat atrophy resolved spontaneously within 1 year. Pediatric ophthalmologists should be aware that fat atrophy is a risk of intratrochlear steroid injections for management of acute Brown syndrome.
BACKGROUND: The current United States screening criteria for retinopathy of prematurity (ROP) is highly sensitive (gestational age [GA] of ≤30 weeks or birthweight [BW] of ≤1500 g) and often result in unnecessary examina...BACKGROUND: The current United States screening criteria for retinopathy of prematurity (ROP) is highly sensitive (gestational age [GA] of ≤30 weeks or birthweight [BW] of ≤1500 g) and often result in unnecessary examinations. Indirect ophthalmoscopic ROP examinations can be stressful for infants and require fellowship-trained ophthalmologists. The purpose of this study was to evaluate the safety of excluding low-risk premature infants: those who only meet one criterion of either GA or BW. METHODS: The medical records of premature infants who underwent ROP screening at a tertiary academic center between 2012 and 2022 were reviewed retrospectively. Demographics, BW, GA, ROP classification, rates of treatment, and need for subsequent inpatient follow-up were compared among patients that met only one criterion (OR group) versus both criteria (AND group). RESULTS: A total of 926 charts were reviewed; 759 patients met the inclusion criteria. Of these, 181 (23.8%) OR neonates were compared to 578 (76.2%) AND neonates. No babies in the OR group developed treatment-requiring type 1 ROP, whereas 52 AND neonates (9.0%) required treatment for type 1 ROP (P < 0.001). Follow-up was necessary for 90 OR group neonates (49.7%) and 462 AND neonates (79.9%) (P < 0.001). CONCLUSIONS: No patients in the OR group developed treatment-requiring disease, suggesting that sensitivity is maintained with the exclusion of single criterion infants. This data, consistent with other published work, suggests use of the current guidelines in developed countries be reexamined to increase specificity and decrease the number of unnecessary ROP examinations.
We report demographics and post-lensectomy outcomes in 30 children (39 eyes) with Down syndrome and cataract. Mean age at first lensectomy was 3.0 years (range, 0.04-12.9); 16 of 30 patients (53%) had lensectomy before 1...We report demographics and post-lensectomy outcomes in 30 children (39 eyes) with Down syndrome and cataract. Mean age at first lensectomy was 3.0 years (range, 0.04-12.9); 16 of 30 patients (53%) had lensectomy before 12 months of age. The 5-year cumulative incidence of glaucoma-related adverse events was 38% (95% CI, 0%-69%); of retinal detachment, 3% (95% CI, 0%-9%). The median myopic shift in children with refractive data at 5 years was -10.00 D (IQR, -12.50 to -8.38 D) in 11 aphakic eyes and -1.50 D (IQR, -3.00 D to -0.25 D) in 7 pseudophakic eyes. The period prevalence (combining cases at baseline with those developing the condition during follow up) of strabismus by 5 years was 81% (95% CI, 40%-94%), and of nystagmus, 68% (95% CI, 41%-83%). In 11 children able to perform optotype testing, 2 of 12 study eyes (17% [95% CI, 3%-56%]) had visual acuity of 20/60 or better at 5 years.
PURPOSE: To evaluate the factors affecting postoperative outcomes in a cohort of patients who underwent combined surgery for horizontal strabismus and visually significant senile cataract. METHODS: We retrospectively rev...PURPOSE: To evaluate the factors affecting postoperative outcomes in a cohort of patients who underwent combined surgery for horizontal strabismus and visually significant senile cataract. METHODS: We retrospectively reviewed the records of adults who underwent combined strabismus and cataract surgery for horizontal strabismus and senile cataracts at a single institution between January 2022 and January 2024. Best-corrected visual acuity, astigmatism, and angle of deviation were analyzed preoperatively, on postoperative day 14, and at last follow-up. RESULTS: A total of 40 eyes of 34 patients (21 females), 58.5 ± 7.1 years of age were included. Mean follow-up was 5.2 months (range, 1-26). All eyes achieved visual success, defined as visual acuity of ≤0.3 logMAR, 30 patients (88%) achieved motor success, and 4 (12%) had residual misalignment at final follow-up. None of the preoperative variables assessed significantly predicted postoperative motor outcome. There were no intra- or postoperative complications in any patients. CONCLUSIONS: In our study cohort, cataract surgery was effective in all patients, strabismus surgery outcomes were comparable to standard horizontal strabismus surgeries, and no complications were noted. The outcomes of neither procedure were compromised by being performed in combination.