Journal of pediatric ophthalmology最新文献

Three families with a total of five patients with Lowe's syndrome are described. We tried to trace female heterozygotes by ophthalmological abnormalities in order to realize prevention of this serious X-chromosomal recessive disease. Of the fourteen female relatives examined, eight showed pathological opacities of the lens, two of these being proven heterozygotes. In our opinion, in Lowe's syndrome, examination of the eyes can play an important role in the detection of heterozygotes.

A one-year-old White female mongoloid child was seen with typical palpebral fissures, esotropia, myopic astigmatism, and nystagmus. Additional uncommon ocular findings included ganglionic neuroretinal hypoplasia (hypoplasia of the optic nerve) and bilateral congenital impatency of the nasolacrimal duct. An active search for these ocular changes is recommended in cases of Down's syndrome.

Seventeen cases of unilateral aphakia secondary to acquired cataracts and dislocated lenses were presented. Final visual acuity was 20/70 or better in 12 of our 17 patients. Binocular single vision has been maintained in four cases. Ten patients had a posttherapy tropia. Early surgery and treatment particularly in the young child is stressed in order to maintain normal binocular single vision. Where once traumatized eyes were felt to be "sick" eyes and better left alone, current surgical and therapeutic methods make restoration of vision and binocularity a reasonable goal.

A congenital teratoma of the orbit is described. Histologically, the tissues forming the tumor appeared derived from the three germinal layers and showed an advanced degree of differentiation. An exenteration was performed because of suspicion of malignant tumor in the orbit and because of the severe keratitis with impending perforation which ensued the lagophthalmos.

Vitreous loss occurred in 50 of 475 consecutive eyes undergoing infantile cataract aspirations over a 10-year period. Vitreous loss occurred in eyes predisposed to such loss and in other eyes following the use of faulty instrumentation, poor surgical judgment, or from errors in operative technique. Vitreous loss was managed by the techniques outlined by Castroviejo and Maumanee. An analysis of this series revealed that the operative loss of vitreous in children does not predispose to undesirable sequelae. Postoperative complications are not correlated with the loss of vitreous itself, but rather with the presence of other coincident ocular pathology and/or the persistence of vitreous in or attached to anterior chamber structures. The final attained visual acuity in patients suffering vitreous loss is not different from the average of the same population. Although vitreous loss consequences may be minimized, the authors do not advocate the disturbance of the intact vitreous face either accidentally or intentionally.

By simplifying a pharmacokinetic treatment, an equation can be derived which predicts that equal areas under aqueous humor concentration-time profiles can be obtained by administering a dose to infants which is some fraction of the normal adult dose. This fraction is obtained by dividing the aqueous humor volume of the child by that of the adult. This theory has been tested using rabbits as an experimental model. Using literature values for aqueous humor volumes, it was possible to calculate what fraction of a dose of pilocarpine administered to 20-day-old rabbits would result in the same ocular concentrations of drug as in 60-day-old rabbits. When the experiment was performed, agreement between predicted and experimental values was excellent. Although admittedly an oversimplified treatment, these results are the first step in a comprehensive pharmacokinetic model which should result in a more rational approach to ophthalmic drug delivery in infants and children.

An arteriovenous fistula developed on the surface of a chronic chalazion of the upper eyelid of a 21-year-old patient during pregnancy. Surgical removal of the vascular mass with ligation of the feeder arteries resulted in a complete cure.