Cataract surgery in children: Complicated cases, trends, and controversies

Volume 15 Number 1 / February 2011 are 13 separate sections in the handout). Presentors select the most relevant articles in their topic sections from the handout to give a quick powerpoint overview of these most important articles. Learning Objectives: Attendees will be able to implement the latest clinical and basic science research into their clinical practices to improve patient care and treatment in a variety of areas of pediatric Ophthalmology. 142 When the patient sees double and the doctor sees nothing. Melinda Rainey, Cheryl McCarrus, Kyle Arnoldi, Jorie Jackson, Rich Freeman, Aaron Miller Relevance: Diplopia can be distressing to both the patient and the clinician. Though some cases are straightfoward, there are those that present with no obvious cause, those in which the symptoms are not consistent with the clinical signs, and those that seem to defy relief with all but occlusion. These are the types of cases that bring a busy clinic to a grinding halt! They take time, patience, and sometimes creativity. Enter the orthoptist. This workshop will cover the diagnosis and management of diplopia and related binocular visual symptoms whose cause is either not readily apparent, or unusual. Delivery Formats: The format of this wokshop will be case presentations, with panel discussion and audience participation. Content: Examples will include paradoxical diplopia with anomalous binocular vision, central loss of fusion, atypical monocular diplopia and retinal diplopia, amoung others. Algorithms for diagnosis and management will be presented to assist the clinician in timely work-up and effective treatment. Learning Objectives: At the end of this workshop, attendees will be able to: 1, Decipher the patient's symptoms to determine whether or not true diplopia is the problem; 2, Peform an efficient and directed sensorimotor exam to reveal the likely casue of the symptoms; 3, Devise an effective treatment to address the patient's symptoms and maximize patient satisfaction. 143 Legislative Committee update. John W. Simon, Oscar Cruz, Kathy Lee, Michael X. Repka Relevance: Access of patients to pediatric ophthalmologists is likely to be influenced by activities in the political arena. Format: Summary discussions of developments on three fronts will be presented by committee members in a panel, with ample opportunity for audience participation. Content: (1) During the year since the Legislative Committee's symposium at the 2010 annual meeting, activity on the optometric mandatory pre-K examination initiative has continued across the country. We will update the membership on legislative contests in several states, including the optometric effort to extend the comprehensive examination law in Missouri. (2) Members of the interorganizational committee have worked to build bridges with other stake-holders, including the State Ophthalmologic Societies and the National Association of School Nurses. (3) In coordination with the American Academy of Ophthalmology, the Committee has worked to define the pediatric vision benefit mandated as "an essential health benefit" under new federal legislation. We will present strategies to ensure that vision care in school- and community-based health centers is cost effective. Learning Objectives: At the completion of this workshop, attendees will be able to identify the political forces that will shape the access of patients to pediatric ophthalmologists and to help implement costeffective care under new federal health care legislation.

Journal of AAPOS

e39 144 OMIC: A watchful eye on retinopathy of prematurity. Paul Weber, Robert Gold Relevance: This workshop will review and discuss hospital-based programs for screening and follow-up of retinopathy of prematurity (ROP). Based on 2006 U.S. birth statistics, 86,523 live births were very pre-term (\32 weeks) and 63,309 live births were very low birthweight (\1500 g). Relying on this data and current American Academy of Pediatrics ROP screening guidelines, one ophthalmologist estimates that there may be as many as 450,000 ROP screening examinations performed in U.S. NICUs each year. These statistics underscore the fact that ROP screening and follow-up are primarily hospital-based. American Hospital Association data indicates that over 1,100 hospitals in the United States have NICUs. Reflecting a commitment to quality of care and patient-safety, some hospitals are adopting a systematic approach, utilizing one central NICU ROP coordinator (ROPC), to ensure that premature infants receive timely ROP screening and follow-up. Delivery Formats: A panel of ophthalmologists and others that have experience with ROP screening examinations will review a model interdisciplinary hospital-based ROP screening and follow-up protocol. Learning Objectives: At the conclusion of this workshop ophthalmologists will be able to implement appropriate accepted protocols for the evaluation and management of infants with ROP. 145 Cataract surgery in children: Complicated cases, trends, and controversies. M. Edward Wilson, Rupal H. Trivedi, Erick D. Bothun, Edward G. Buckley, Scott Lambert, David Plager Relevance: Cataract surgery in children is evolving. It remains uniquely challenging and substantially different from surgery in adults. In addition, new cataract surgery innovations developed for adult eyes may or may not be appropriate for children. This workshop is presented on behalf of the Pediatric Clinical Committee of the American Association of Cataract and Refractive Surgery and will present a 2011 update of trends and controversies in pediatric cataract surgery. Delivery Formats: The workshop is mostly video-based using complicated cases and those with complications. Word slides are used only as an update of a trend or controversy. Panel and audience discussion will be used throughout. Content: The following topics will be discussed and/or illustrated: (1) IOL choice (hydrophilic vs hydrophobic ; multifocal vs monofocal) in various situations including sulcus, capsular bag, young children, older children; (2) capsular controversies including the elastic capsule, capsular fibrosis, posterior capsule defects, and after-cataract treatment; (3) 20-gauge, 23-gauge or 25-gauge instrumentation; (4) the use of trypan blue, triamcinolone, intracameral antibiotics. Learning Objectives: At the conclusion of the workshop, attendees will be able to list the list the pros and cons of the use 20-, 23-,or 25-gauge instruments, select appropriate patients for multifocal or accommodating IOLs, and discuss the approach to complicated cataracts in children. 146 New insights into amblyopia: Perceptual deficits and treatment. Agnes Wong, Robert Hess, Benjamin Thompson Relevance: Amblyopia is a visual impairment caused by disruption of vision during early childhood. In addition to acuity and contrast sensitivity loss, it is also associated with higher-order perceptual deficits. Amblyopia is often thought to be incurable in adult patients because of a lack of neuroplasticity after the critical period of development. In this workshop, we will review the most recent developments in amblyopia research, including how amblyopia affects the