Pub Date : 2025-12-01Epub Date: 2025-11-20DOI: 10.1016/j.jaapos.2025.104694
Omi Pang MD , Nabiha Habib MD , Julie Conley MD , Lauren Fletcher-Morehouse DO , Brooke Geddie DO
Background
Current screening criteria for retinopathy of prematurity (ROP) follow the American Academy of Pediatrics (AAP) guidelines. However, the Postnatal Growth and Retinopathy (G-ROP) study has proposed newer criteria, showing 100% sensitivity for detecting type 1 ROP while reducing the number of infants requiring dilated retinal examinations by 30%. The purpose of this study was to validate the G-ROP criteria in a midsized Midwestern children’s hospital.
Methods
We conducted a retrospective cohort study of infants screened for ROP between January 2018 and December 2022 under AAP guidelines. We then applied the G-ROP criteria to the same cohort and evaluated the sensitivity and specificity of these guidelines for detecting type 1 ROP requiring treatment.
Results
A total of 687 infants were included. The average gestational age 28 weeks; the average birthweight, 1022.5 g. Of the 687 infants screened by standard of care (SOC) criteria, 448 (65.2%) met G-ROP criteria. Using SOC criteria, 34 infants (4.9%) developed type 1 ROP necessitating treatment. However, when using G-ROP screening criteria, 33 of 448 (7.4%) with type 1 ROP were identified. The sensitivity of G-ROP for detecting type 1 ROP was 97.1%, but 1 infant who required treatment was missed.
Conclusions
G-ROP criteria demonstrated high sensitivity but did not match the 100% sensitivity from earlier studies. The single infant with type 1 ROP missed by G-ROP screening had a medical history of twin-to-twin transfusion syndrome. The physiologic factors of twin-to-twin transfusion syndrome could be important to explore when considering ROP screening criteria.
{"title":"Evaluating the G-ROP criteria sensitivity for type 1 ROP in a North American cohort","authors":"Omi Pang MD , Nabiha Habib MD , Julie Conley MD , Lauren Fletcher-Morehouse DO , Brooke Geddie DO","doi":"10.1016/j.jaapos.2025.104694","DOIUrl":"10.1016/j.jaapos.2025.104694","url":null,"abstract":"<div><h3>Background</h3><div>Current screening criteria for retinopathy of prematurity (ROP) follow the American Academy of Pediatrics (AAP) guidelines. However, the Postnatal Growth and Retinopathy (G-ROP) study has proposed newer criteria, showing 100% sensitivity for detecting type 1 ROP while reducing the number of infants requiring dilated retinal examinations by 30%. The purpose of this study was to validate the G-ROP criteria in a midsized Midwestern children’s hospital.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of infants screened for ROP between January 2018 and December 2022 under AAP guidelines. We then applied the G-ROP criteria to the same cohort and evaluated the sensitivity and specificity of these guidelines for detecting type 1 ROP requiring treatment.</div></div><div><h3>Results</h3><div>A total of 687 infants were included. The average gestational age 28 weeks; the average birthweight, 1022.5 g. Of the 687 infants screened by standard of care (SOC) criteria, 448 (65.2%) met G-ROP criteria. Using SOC criteria, 34 infants (4.9%) developed type 1 ROP necessitating treatment. However, when using G-ROP screening criteria, 33 of 448 (7.4%) with type 1 ROP were identified. The sensitivity of G-ROP for detecting type 1 ROP was 97.1%, but 1 infant who required treatment was missed.</div></div><div><h3>Conclusions</h3><div>G-ROP criteria demonstrated high sensitivity but did not match the 100% sensitivity from earlier studies. The single infant with type 1 ROP missed by G-ROP screening had a medical history of twin-to-twin transfusion syndrome. The physiologic factors of twin-to-twin transfusion syndrome could be important to explore when considering ROP screening criteria.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 6","pages":"Article 104694"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-20DOI: 10.1016/j.jaapos.2025.104693
Qais A. Dihan MD , Andrew D. Brown OD, MD , Ahmad F. Alzein BS , Ana T. Zaldivar MD , Kendall E. Montgomery MD , Mohamed M. Khodeiry MD, MSc , Reem H. ElSheikh MD , Michelle Attzs MD, MSc, FRCOphth , Mehmet C. Mocan MD, MPH , Douglas Fredrick MD , Catherine O. Jordan MD , Janine Collinge MD , Abdelrahman M. Elhusseiny MD, MSc
Background
Parental health literacy significantly affects pediatric ophthalmology follow-up care and adherence to treatment regimens. Yet patient education materials (PEMs) often exceed the American Medical Association’s recommended 6th-grade reading level. Large-language models (LLMs) can improve the readability of PEMs without sacrificing quality. This study evaluated the baseline readability, quality, and accuracy of PEMs by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and assessed how LLMs may improve these PEMs.
Methods
This cross-sectional study analyzed 111 PEMs from the AAPOS website. Readability was assessed using the Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG). Quality and understandability were evaluated using the DISCERN and the Patient Education Materials Assessment Tool (PEMAT), respectively. Accuracy was assessed using the Likert misinformation scale. Each PEM was separately rewritten by ChatGPT-4 and Gemini Advanced after initial analysis. Changes were analyzed.
Results
Baseline PEMs were written on average at a 9th-grade reading level (SMOG, 9.0 ± 1.6; FKGL, 9.6 ± 2.1), with only 3.6% meeting the 6th-grade recommendation. ChatGPT-4 rewrites improved readability to a 7th-grade level without compromising quality, while Gemini Advanced rewrites met the 6th-grade threshold but showed modestly reduced quality (DISCERN: 3; P < 0.001). Both models enhanced understandability (ChatGPT-4, 90.9%; Gemini Advanced, 91.3%; [P < 0.001]), and their rewrites contained no misinformation (Likert = 1).
Conclusions
AAPOS PEMs were high in quality and accurate at baseline, but written at a high school level. As supplemental tools, LLMs can improve PEMs’ readability and understandability. PEMs should be thoroughly reviewed by physicians to ensure optimal safety and education.
{"title":"Enhancing patient and parent education in pediatric ophthalmology using artificial intelligence: a report by the AAPOS Public Information Committee","authors":"Qais A. Dihan MD , Andrew D. Brown OD, MD , Ahmad F. Alzein BS , Ana T. Zaldivar MD , Kendall E. Montgomery MD , Mohamed M. Khodeiry MD, MSc , Reem H. ElSheikh MD , Michelle Attzs MD, MSc, FRCOphth , Mehmet C. Mocan MD, MPH , Douglas Fredrick MD , Catherine O. Jordan MD , Janine Collinge MD , Abdelrahman M. Elhusseiny MD, MSc","doi":"10.1016/j.jaapos.2025.104693","DOIUrl":"10.1016/j.jaapos.2025.104693","url":null,"abstract":"<div><h3>Background</h3><div>Parental health literacy significantly affects pediatric ophthalmology follow-up care and adherence to treatment regimens. Yet patient education materials (PEMs) often exceed the American Medical Association’s recommended 6th-grade reading level. Large-language models (LLMs) can improve the readability of PEMs without sacrificing quality. This study evaluated the baseline readability, quality, and accuracy of PEMs by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) and assessed how LLMs may improve these PEMs.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed 111 PEMs from the AAPOS website. Readability was assessed using the Flesch-Kincaid Grade Level (FKGL) and Simple Measure of Gobbledygook (SMOG). Quality and understandability were evaluated using the DISCERN and the Patient Education Materials Assessment Tool (PEMAT), respectively. Accuracy was assessed using the Likert misinformation scale. Each PEM was separately rewritten by ChatGPT-4 and Gemini Advanced after initial analysis. Changes were analyzed.</div></div><div><h3>Results</h3><div>Baseline PEMs were written on average at a 9th-grade reading level (SMOG, 9.0 ± 1.6; FKGL, 9.6 ± 2.1), with only 3.6% meeting the 6th-grade recommendation. ChatGPT-4 rewrites improved readability to a 7th-grade level without compromising quality, while Gemini Advanced rewrites met the 6th-grade threshold but showed modestly reduced quality (DISCERN: 3; <em>P</em> < 0.001). Both models enhanced understandability (ChatGPT-4, 90.9%; Gemini Advanced, 91.3%; [<em>P</em> < 0.001]), and their rewrites contained no misinformation (Likert = 1).</div></div><div><h3>Conclusions</h3><div>AAPOS PEMs were high in quality and accurate at baseline, but written at a high school level. As supplemental tools, LLMs can improve PEMs’ readability and understandability. PEMs should be thoroughly reviewed by physicians to ensure optimal safety and education.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 6","pages":"Article 104693"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-18DOI: 10.1016/j.jaapos.2025.104641
Manjushree Bhate MD , Venkatesh Pochaboina MSc , Ravi Varma MD, DM , Sarah Bailur DNB, FICG , Alex V. Levin MD, MHSc , Frank J. Martin FRANZCO
We describe the ophthalmic features in 2 siblings with genetically confirmed Cousin syndrome. Each sibling had a very large–angle exotropia with minimal ocular motility in any position of gaze. The younger had severe ptosis. Magnetic resonance imaging of the brain revealed multiple skull abnormalities but normal cranial nerve pathways and normal extraocular muscles. On exploration, the lateral rectus muscles were extremely tight. Forced duction testing was positive for all rectus muscles, with no rotation of the globe toward adduction and least positive for abduction. A homozygous pathogenic variant in TBX15 was identified.
{"title":"Ophthalmic manifestations of Cousin syndrome","authors":"Manjushree Bhate MD , Venkatesh Pochaboina MSc , Ravi Varma MD, DM , Sarah Bailur DNB, FICG , Alex V. Levin MD, MHSc , Frank J. Martin FRANZCO","doi":"10.1016/j.jaapos.2025.104641","DOIUrl":"10.1016/j.jaapos.2025.104641","url":null,"abstract":"<div><div>We describe the ophthalmic features in 2 siblings with genetically confirmed Cousin syndrome. Each sibling had a very large–angle exotropia with minimal ocular motility in any position of gaze. The younger had severe ptosis. Magnetic resonance imaging of the brain revealed multiple skull abnormalities but normal cranial nerve pathways and normal extraocular muscles. On exploration, the lateral rectus muscles were extremely tight. Forced duction testing was positive for all rectus muscles, with no rotation of the globe toward adduction and least positive for abduction. A homozygous pathogenic variant in <em>TBX15</em> was identified.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104641"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-18DOI: 10.1016/j.jaapos.2025.104638
John E. Williamson III MD , Laurel Lam BS , Nina R. Spitofsky BA , Alexandra R. Zaloga BA , Sudheshna Vemula BS , Gabriella Baldassarre BS , Sara Flanagan , Rebecca J. Elias MFA , Bruce M. Schnall MD , Kammi B. Gunton MD , Barry N. Wasserman MD
Purpose
To characterize how pediatric screening demographic characteristics changed after the COVID-19 pandemic in children attending Give Kids Sight Day (GKSD), a free vision screening program in Philadelphia.
Methods
Three data sets were analyzed: (1) prospective survey from guardians attending GKSD 2023, (2) retrospective analysis of GKSD attendee records, and (3) pre-pandemic (2009-2020) GKSD data.
Results
A total of 293 children attended GKSD in 2023, and 189 surveys were completed. Compared with pre-pandemic GKSD events, there were more repeat participants (15% to 26% [P < 0.001]), greater percentage uninsured (26%-27% to 38% [P < 0.001]), and more insured without vision coverage (30% to 46% [P = 0.002]). More children required refractive correction (28%-61% to 76% [P < 0.001]) and subsequent follow-up (10%-15% to 17% [P = 0.004]). Of children receiving their first pair of glasses, 47% had not failed a previous vision screening. Ninety-one percent of missed appointments were for first-time attendees. Eye-care-naive attendees commonly learned of GKSD from school (59%). Perceived barriers to care were diverse and equally distributed among respondents.
Conclusions
Since the COVID-19 pandemic, insurance coverage for vision care has declined, with rising unmet ophthalmic needs in event attendees. Many children with refractive pathology had never failed prior school-based vision screening, suggesting lapses in current screening systems. School-based initiatives, funding, and community social worker support are needed to connect eye-care-naive patients with ophthalmic care, ensure community screening is completed effectively, and connect families to subsidized insurance plans.
{"title":"Post-pandemic changes in demographics and outcomes of children at an inner-city vision outreach program: Give Kids Sight Day","authors":"John E. Williamson III MD , Laurel Lam BS , Nina R. Spitofsky BA , Alexandra R. Zaloga BA , Sudheshna Vemula BS , Gabriella Baldassarre BS , Sara Flanagan , Rebecca J. Elias MFA , Bruce M. Schnall MD , Kammi B. Gunton MD , Barry N. Wasserman MD","doi":"10.1016/j.jaapos.2025.104638","DOIUrl":"10.1016/j.jaapos.2025.104638","url":null,"abstract":"<div><h3>Purpose</h3><div>To characterize how pediatric screening demographic characteristics changed after the COVID-19 pandemic in children attending Give Kids Sight Day (GKSD), a free vision screening program in Philadelphia.</div></div><div><h3>Methods</h3><div>Three data sets were analyzed: (1) prospective survey from guardians attending GKSD 2023, (2) retrospective analysis of GKSD attendee records, and (3) pre-pandemic (2009-2020) GKSD data.</div></div><div><h3>Results</h3><div>A total of 293 children attended GKSD in 2023, and 189 surveys were completed. Compared with pre-pandemic GKSD events, there were more repeat participants (15% to 26% [<em>P</em> < 0.001]), greater percentage uninsured (26%-27% to 38% [<em>P</em> < 0.001]), and more insured without vision coverage (30% to 46% [<em>P</em> = 0.002]). More children required refractive correction (28%-61% to 76% [<em>P</em> < 0.001]) and subsequent follow-up (10%-15% to 17% [<em>P</em> = 0.004]). Of children receiving their first pair of glasses, 47% had not failed a previous vision screening. Ninety-one percent of missed appointments were for first-time attendees. Eye-care-naive attendees commonly learned of GKSD from school (59%). Perceived barriers to care were diverse and equally distributed among respondents.</div></div><div><h3>Conclusions</h3><div>Since the COVID-19 pandemic, insurance coverage for vision care has declined, with rising unmet ophthalmic needs in event attendees. Many children with refractive pathology had never failed prior school-based vision screening, suggesting lapses in current screening systems. School-based initiatives, funding, and community social worker support are needed to connect eye-care-naive patients with ophthalmic care, ensure community screening is completed effectively, and connect families to subsidized insurance plans.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104638"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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 χ2 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.
背景:近几十年来,随着女性参与的增加,学术儿科眼科的性别代表性发生了显著变化。本研究考察了学术等级、领导角色和研究生产力作为性别的功能。方法:这项横断面研究分析了2024年8月在奖学金和住院医师电子互动数据库(FREIDA)中列出的126个美国学术眼科项目的公开数据。从机构网站收集的数据确定了451名接受过奖学金培训的儿科眼科医生。变量包括性别、奖学金毕业年份、学术等级、领导角色(如系主任、奖学金主任、项目主任)和研究效率指标(出版物、引用、h指数)。统计学比较采用Pearson χ2检验、Fisher精确检验和Mann-Whitney U或t检验,在适当的情况下,显著性定义为P < 0.05。结果:女性占学院派儿童眼科医生的55.9%(252/451)。在2000年以前完成奖学金的人中,男性的比例比女性大(69.7%比30.3%);自2000年以来,女性占奖学金毕业生的比例更大(65.3%对34.7% [P < 0.01])。男性更多地担任正教授(40.9% vs 18.0%)。结论:在高级职位上,性别差异仍然存在,但最近的在职教师群体显示出相似的学术等级和研究生产力水平。目前,女性在学术儿科眼科医生中占55.9%,在2000后毕业生中占65.3%。
{"title":"Progress toward gender equity in leadership and representation in academic pediatric ophthalmology","authors":"Brenton T. Bicknell BS , Josephine Rudd Zhong Manis BS , Haley Chishom BS , Yejin Heo BS , Lance Dzubinski BS , Taylor L. Aaserud BS , Alvina Liang BS , Shayan Massoumi BS , Thanushri Srikantha BS , Stephanie Goei MD , Robert Tauscher MD","doi":"10.1016/j.jaapos.2025.104608","DOIUrl":"10.1016/j.jaapos.2025.104608","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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<sup>2</sup> test, the Fisher exact test, and Mann-Whitney <em>U</em> or <em>t</em> tests, where appropriate, with significance defined as <em>P</em> < 0.05.</div></div><div><h3>Results</h3><div>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% [<em>P</em> < 0.01]). Men more frequently serve as full professors (40.9% vs 18.0%, <em>P</em> <0.01]) and department chairs (6.5% vs 2.0% [<em>P</em> = 0.02]; women, more often as assistant professors (54.5% vs 40.1% [<em>P</em> = 0.01]) and program directors (3.6% vs 0.5% [<em>P</em> = 0.03]). Research productivity and academic rank are similar between genders in post-2000 graduates.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104608"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-18DOI: 10.1016/j.jaapos.2025.104644
B. Michelle Kim BS , Grayson B. Ashby MD , Brian G. Mohney MD
Background
Published reports, all of which are underpowered to detect a difference, demonstrate conflicting findings on the benefit of inferior turbinate infracture during congenital nasolacrimal duct (CNLD) probing. The purpose of this study was to report the effect of inferior turbinate infracture on outcomes of CNLD probing and assess for long-term complications from the procedure.
Methods
The medical records of all patients <6 years of age who underwent probing for congenital nasolacrimal duct obstruction (CNLDO) at a single referral center from January 1, 2002, through December 31, 2018, were retrospectively reviewed.
Results
Of 987 consecutive probing procedures, 184 (18.6%) underwent inferior turbinate infracture. The mean age at diagnosis and surgery, prevalence of prematurity, race, and sex did not differ between the infracture and control groups. Probing success was similar between infracture (80.4%) and control (80.6%) groups (P = 0.916). The subsequent development of long-term nasopharyngeal disorders including sleep apnea, chronic rhinitis, and chronic sinusitis was no different between groups. Subgroup analysis comparing outcomes of first-time probing versus first-time probing with infracture and single-surgeon analysis maintained no significant difference in outcomes between the two groups. Only late probings (age ≥24 months) tended to be more successful (but not significantly so; P = 0.16) when combined with an infracture (87.3%) compared with those without infracture (78.8%).
Conclusions
Concurrent inferior turbinate infracture did not significantly improve probing success for children with CNLDO in this cohort. However, because potential nasopharyngeal complications are unlikely, the procedure may safely be considered. Future studies should clarify the benefit of infracture for children ≥24 months of age.
{"title":"Effect of inferior turbinate infracture on outcomes of probing for congenital nasolacrimal duct obstruction","authors":"B. Michelle Kim BS , Grayson B. Ashby MD , Brian G. Mohney MD","doi":"10.1016/j.jaapos.2025.104644","DOIUrl":"10.1016/j.jaapos.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>Published reports, all of which are underpowered to detect a difference, demonstrate conflicting findings on the benefit of inferior turbinate infracture during congenital nasolacrimal duct (CNLD) probing. The purpose of this study was to report the effect of inferior turbinate infracture on outcomes of CNLD probing and assess for long-term complications from the procedure.</div></div><div><h3>Methods</h3><div>The medical records of all patients <6 years of age who underwent probing for congenital nasolacrimal duct obstruction (CNLDO) at a single referral center from January 1, 2002, through December 31, 2018, were retrospectively reviewed.</div></div><div><h3>Results</h3><div>Of 987 consecutive probing procedures, 184 (18.6%) underwent inferior turbinate infracture. The mean age at diagnosis and surgery, prevalence of prematurity, race, and sex did not differ between the infracture and control groups. Probing success was similar between infracture (80.4%) and control (80.6%) groups (<em>P</em> = 0.916). The subsequent development of long-term nasopharyngeal disorders including sleep apnea, chronic rhinitis, and chronic sinusitis was no different between groups. Subgroup analysis comparing outcomes of first-time probing versus first-time probing with infracture and single-surgeon analysis maintained no significant difference in outcomes between the two groups. Only late probings (age ≥24 months) tended to be more successful (but not significantly so; <em>P</em> = 0.16) when combined with an infracture (87.3%) compared with those without infracture (78.8%).</div></div><div><h3>Conclusions</h3><div>Concurrent inferior turbinate infracture did not significantly improve probing success for children with CNLDO in this cohort. However, because potential nasopharyngeal complications are unlikely, the procedure may safely be considered. Future studies should clarify the benefit of infracture for children ≥24 months of age.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104644"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-26DOI: 10.1016/j.jaapos.2025.104654
Jenny Chun Ling Kuo MD, MPH , Xinxing Guo MD, PhD , Megan E. Collins MD, MPH
Obtaining parental consent is a crucial step for students to receive eye examinations in school-based vision programs (SBVPs). Using paper consent forms is challenging and may limit responses. We explored a novel, phased, multimodal consent approach in a Baltimore SBVP to increase program participation during the 2022-23 school year. Vision screenings were provided for all students as part of the program. Consent outreach was conducted for all students prior to vision screening (universal phase) and again after for students who failed a vision screening (targeted phase). Email consent only was used during the universal phase, whereas a tiered approach that combined email, paper, and telephone was used in the targeted phase. Of the 46 schools that implemented multimodal consenting, the mean overall consent response rate was 86% ± 9.3% (range, 62%-99%). Mean universal and targeted consent response rate was 15% (95% CI, 13%-18%) and 71% (95% CI, 68%-74%), respectively. Among targeted consent responses, 10% were obtained by email, 26% by paper, and 64% by telephone.
{"title":"Phased multimodal consent in a Baltimore school-based vision program: a novel approach","authors":"Jenny Chun Ling Kuo MD, MPH , Xinxing Guo MD, PhD , Megan E. Collins MD, MPH","doi":"10.1016/j.jaapos.2025.104654","DOIUrl":"10.1016/j.jaapos.2025.104654","url":null,"abstract":"<div><div>Obtaining parental consent is a crucial step for students to receive eye examinations in school-based vision programs (SBVPs). Using paper consent forms is challenging and may limit responses. We explored a novel, phased, multimodal consent approach in a Baltimore SBVP to increase program participation during the 2022-23 school year. Vision screenings were provided for all students as part of the program. Consent outreach was conducted for all students prior to vision screening (universal phase) and again after for students who failed a vision screening (targeted phase). Email consent only was used during the universal phase, whereas a tiered approach that combined email, paper, and telephone was used in the targeted phase. Of the 46 schools that implemented multimodal consenting, the mean overall consent response rate was 86% ± 9.3% (range, 62%-99%). Mean universal and targeted consent response rate was 15% (95% CI, 13%-18%) and 71% (95% CI, 68%-74%), respectively. Among targeted consent responses, 10% were obtained by email, 26% by paper, and 64% by telephone.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104654"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-18DOI: 10.1016/j.jaapos.2025.104648
Praveen Jeyaseelan MD, Daniel Timothy Harrast
A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.
{"title":"Horner syndrome secondary to otomastoiditis","authors":"Praveen Jeyaseelan MD, Daniel Timothy Harrast","doi":"10.1016/j.jaapos.2025.104648","DOIUrl":"10.1016/j.jaapos.2025.104648","url":null,"abstract":"<div><div>A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104648"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.
{"title":"Modified Nishida’s procedure combined with medial rectus recession in a case of Moebius syndrome","authors":"Sowmya Raveendra Murthy MS, FICO, Sahil Sharma MS, FPOS","doi":"10.1016/j.jaapos.2025.104652","DOIUrl":"10.1016/j.jaapos.2025.104652","url":null,"abstract":"<div><div>Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104652"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-19DOI: 10.1016/j.jaapos.2025.104649
R. Michael Siatkowski MD, MBA
{"title":"How do we fix this mess?","authors":"R. Michael Siatkowski MD, MBA","doi":"10.1016/j.jaapos.2025.104649","DOIUrl":"10.1016/j.jaapos.2025.104649","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104649"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}