Modified test protocol improves sensitivity of the stereo fly test

e30 elementary school children. Poor baseline visual acuity and hyperopia were associated with reduced reading achievement. Follow-up vision and reading assessments are planned 1 year after enrollment and will determine whether study-provided glasses and vergence exercises affected reading performance. 108 Strabismus developing after unilateral and bilateral congenital cataract surgery in healthy children. Ran David, Jenya Davelman, Hadas Mechoulam, Evelyne Cohen, Ilana Karshai, Irene Anteby Introduction: Strabismus is a prevalent complication of children who have been operated for congenital cataract. This study aim is to evaluate the prevalence of strabismus after unilateral or bilateral congenital cataract surgery, with or without intraocular lens implantation. Methods: Medical records of pediatric patients were evaluated from 2000 to 2011. Healthy children undergoing surgery for unilateral or bilateral congenital cataract with at least 1 year of follow-up were included. Results: Ninety patients were included, 40% had unilateral and 60% had bilateral cataracts. Follow-up was on average 50.71 months. Strabismus was found preoperatively in 34.4% children, and in 43.3% children at last follow-up. Strabismus developed in 46.2% of children who were orthotropic pre-operatively. Strabismus occurred after unilateral or bilateral cataract surgery in 63.9% and 29.6% children, respectively. At last follow-up, strabismus was found in 46.7% of aphakic and 58.7% of pseudophakic children (P 5 0.283). Children who developed strabismus were generally operated at a younger age as compared to those without strabismus (mean, of 25.9 vs 52.7 months, P \ 0.001). Final visual acuity was inversely correlated with prevalence of strabismus. Discussion: We found risk factors for strabismus after congenital cataract surgery to be unilateral cases and young age at surgery. Our result is in accordance with other major studies. No correlation was found between prevalence of strabismus and use of intraocular lens. Strabismus was more common in children with poor final visual acuity. Conclusions: Pediatric ophthalmologist should carefully monitor for the possibility of strabismus development in children who undergo congenital cataract surgery, especially when with aforementioned risk factors. 109 Modified test protocol improves sensitivity of the stereo fly test. Angie S. De La Cruz, Reed M. Jost, Sarah E. Morale, Krista R. Kelly, Eileen E. Birch Introduction: Many pediatric vision disorders result in degraded stereoacuity. While random-dot stereograms, ranging in disparities up to 1200 arcsec, are preferable for eliminating monocular cues, the Stereo Fly Test (Fly) is routinely used to establish the presence of coarse stereopsis (3000 sec of arc). Unfortunately, the Fly yields a high rate of false negatives due to monocular cues and learned response due to frequent testing. We present a modified administration of the Fly aimed at increasing sensitivity. Methods: The Fly was administered following manufacturer instructions to children aged 3-12 years (n 5 380) wearing standard 3-D polarized glasses with opposite orientation of polarizers for each eye. Children conveying a "pass" response by pinching above the plate (n 5 261) were retested wearing glasses fitted with polarized lenses of the same orientation for both eyes, eliminating disparity cues. Children who pinched above the plate with modified glasses

Volume 20 Number 4 / August 2016 were then considered a false pass. Randot Preschool Stereoacuity Test was used as the gold standard. Results: When presenting the Fly according to standard instructions, specificity was 100% (95% CI, 0.97-1.00) while sensitivity was 81% (95%CI, 0.75-0.86), with positive predictive value of 81% (95% CI, 0.75-0.86). Utilizing responses given with the modified glasses, sensitivity increased significantly to 96% (95%CI, 0.91-0.98), and positive predictive value increased to 91% (95% CI, 0.82-0.96). Discussion: The modified Fly is quick and convenient to implement and decreases the false negative rate. Conclusions: When random-dot stereoacuity is not present, assessment of coarse stereopsis with the standard plus the modified Fly will provide an accurate assessment of binocularity. 110 The effects of the retinopathy of prematurity examination in premature neonates. Jennifer A. Dunbar, Danilyn M. Angeles, John C. Tan, Andrew Hopper, Christopher G. Wilson, Erin E. Hoch Introduction: To determine the systemic effects of retinopathy of prematurity (ROP) examination in premature neonates, we measured oxygen saturation (SpO2), heart rate (HR), abdominal somatic tissue oxygen saturation (StO2) and urinary biomarkers of hypoxia and oxidative stress. Methods: Data collection was started 12-24 hours before the exam and up to 24 hours after the exam. SpO2, and HR were recorded using a Masimo Radical-7. StO2 was recording using CASMED's FORESIGHT Tissue Oximeter. Urine collection was done by placing cotton balls in the baby's diaper and extracted with a syringe. Urinary concentration of purines (hypoxanthine, xanthine and uric acid) were measured using HPLC. Results: We enrolled 9 subjects to this pilot trial. We found that HR and SpO2 were not significantly different before, during, and 12 hours after examination. We found that StO2 decreased during the exam, and was significantly lower than baseline at 150 seconds of the examination. We also found a trend for decreased SpO2, HR, and increased apnea episodes within the 24-hour period after the examination. In subjects with higher oxygen requirement, urinary purine concentration increased during the 6-hour period after the examination. Discussion: Our pilot data showed a decrease in abdominal StO2 during the ROP exam, despite a stable HR and SpO2. The mechanism for this finding is unclear, although it could be a pain-related sympathetic vasoconstriction to the gastrointestinal vasculature. Conclusions: The ROP examination may alter abdominal StO2. More data is required to determine the mechanism as well as the systemic effects of this preliminary finding. 111 Surgical treatment of inferior oblique overaction: myectomy versus anterior transposition. Jon Durnian, Claire Voas-Clarke, Jane Young, Vicki Wong, Stephen B. Kaye Introduction: There are many surgical strategies to combat inferior oblique overaction; two of the most popular are myectomy (IOM) and anterior transposition (IOAT). We performed a retrospective audit to compare these procedures. Methods:A retrospective audit of all patients that underwent surgical correction of their IOOA from 2005-2012 was performed with any patient having less than complete data being excluded. The four-month postoperativeerative data was compared to the pre-operative data using non-parametric testing. Results: 35 patients had full data; 19 following IOM and 16 IOAT. Both groups showed significant reduction in vertical deviation in all gaze

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