An augmentated Anderson procedure combined with tenotomy/re-insertion of the remaining horizontal recti appears effective at correcting a CHP in null point nystagmus. Compared to other procedures, this operation is technically easy, preserves future surgical options, may avoid overcorrections, may maximally dampen nystagmus, and is more comfortable for the patient.
Patients with infantile esotropia and manifest latent nystagmus adopt a face turn towards the fixing eye as a nystagmus dampening mechanism. The surgical plan should aim to correct both the face turn and the strabismus. Reversal of the face turn after surgery for the strabismus can be (i.e. was) distressing for both the surgeon and the patient and has not been reported previously to the best of our knowledge. We report our patient with a transient reversal of face turn after surgery.
Purpose: Recent technological advances in photoscreening devices have improved their performance for pediatric vision screening. Monocular noncycloplegic autorefractors have also been used but cannot assure that accommodation is held constant between the two eyes. In this study we utilized a simple childrens near autorefraction without correction on the open field Grand Seiko autorefractor to determine if it alone could be a viable method of pediatric vision screening to detect amblyopia risk factors.
Design: Retrospective chart review.
Participants: Fifty-two consecutive children with known amblyopia risk factors were enrolled into this study.
Methods: Children had their accommodation measured at one third of a meter without glasses correction.
Main outcome: In our study children with amblyopia or amblyopia risk factors were found to have abnormal readings indicating either poor ability to focus, or high refractive error. All children measuring minus 1.25 diopter of sphere or higher (less negative), or measuring plus 1.25 diopters of astigmatism or more without correction were found to have amblyogenic factors based on the standard, AAPOS referral criteria.
Conclusion: Children with amblyopia or amblyopia risk factors have classifiably abnormal autorefraction readings at near on the Grand Seiko binocular open field autorefractor. Measuring near autorefraction utilizing the Grand Seiko autorefractor may be a new and viable option for pediatric vision screening in the medical home (defined as the patients primary care doctor, which in this case could be a family doctor or a pediatrician).
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