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Episodic excessive blinking in children
e52 is higher in infantile exotropia than in other forms of childhood strabismus. Conclusions: Routine neurologic screening of otherwise normal infants with infantile exotropia is not indicated. Most children achieve good long-term alignment with one or two surgeries.
156 Parent experiences and perspectives on medical services for their children with albinism: a qualitative study. Kelly E. Lusk, Anne L. Corn, Terry L. Schwartz Introduction: For parents of children with visual impairments, including albinism, it is often difficult to navigate the array of medical services. The purpose of this study was to investigate experiences and perspectives of parents regarding their childrens medical care (specifically, but not limited to, pediatric ophthalmologists and primary eye care physicians) via guided focus groups. Methods: Parents of children with albinism were recruited through participation at the National Organization of Albinism and Hypopigmentation Conference in July 2014. Focus groups were conducted on four separate occasions during the conference. Results: Thirty-seven parents from across the U.S. and Canada participated in focus groups. Overall themes from the focus groups included knowledge level of albinism, coordination of services/interdisciplinary approach to services, referral practices regarding pediatric low vision services and local school systems, and expectations for future visual and independent functioning. Discussion: Parents had both positive and negative experiences/ perspectives regarding medical services. Many parents were not aware of some medical services/resources that other parents discussed. There are wide differences in parents statements about how medical services are provided to children with albinism. Conclusions: These data give insight into how families perceive experiences with medical professionals, including pediatric ophthalmologists. This information can aid pediatric ophthalmologists and their staff, in understanding how and why parents may be satisfied or dissatisfied with the care their children receive. A quantitative study is currently underway on this same topic to further investigate and provide additional guidance to pediatric ophthalmologists and other medical professionals regarding the care of patients with albinism.
157 Episodic excessive blinking in children. Yasmin P. Mali, John W. Simon, Imran A. Chaudhri, Jitka Zobal-Ratner, Gerard P. Barry Introduction: Many children present with excessive blinking. Categorization, associated conditions, and prognosis are controversial. Methods: All children with excessive blinking were reviewed, excluding those with known uveitis, glaucoma, or obvious eyelid abnormalities. Parents were telephoned for follow-up. Results: A total of 74 children (54 boys), aged 1 to 10 years (mean, 4.7), had excessive blinking for 3 days to 1.5 years (mean, 2.5 months). Parents were contacted in 55% of cases. In 26, parents could not identify a cause. In 2, Tourette syndrome was diagnosed, 1 following presentation. In 2, dexmethylphenidate (a stimulant used for ADHD) was suspected to be the cause. There was complete resolution in 29, some improvement
Volume 19 Number 4 / August 2015 in 8, and no improvement in 4 cases. No new ophthalmologic diagnoses were uncovered. Discussion: All children with excessive blinking should undergo ophthalmologic examination. Families should be encouraged to follow-up as needed for redness, light sensitivity, or other eye symptoms. If blinking persists, further evaluations can be coordinated with the pediatrician. Conclusions: Episodes of excessive blinking rarely indicate neurologic disorders and frequently resolve spontaneously.
158 Prevalence and clinical characteristics of ocular disease in children with HIV/AIDS. Taliva D. Martin, Maya S. Ling, Emmett T. Cunningham, Ann Petru, Susan H. Day Introduction: Describe the prevalence and clinical characteristics of ocular disease in children with HIV/ AIDS. Methods: Charts of patients less than 18 years old followed at the HIV/AIDS clinic at UCSF Benioff/ Childrens Hospital Oakland between March 2012 and May 2014 were reviewed. Patients who consented for the study underwent an eye examination by a pediatric ophthalmologist. Results: Charts of 50 patients were reviewed. Thirty-six (72%) underwent an eye examination, including 19 (52.8%) girls and 17 (47.2%) boys. Age at time of examination ranged from 3 to 17 years (mean, 11.4 years; median, 11.0 years). Mean and median CD4 count were 814.4 cells/microliter and 772.5 cells/microliter, respectively. In 31 patients (86.1%) visual acuity was 20/20 at final followup. Four patients (11.1%) had interpalpebral conjunctival injection, and 1 each (2.8%) had an accommodative esotropia, an intermittent exotropia, congenital ptosis, peripheral lattice degeneration, retinal scars from previous treatment of retinopathy of prematurity, hypopigmented retinal lesions, hyperpigmented retinal lesion, and HIVassociated retinal vasculitis and optic neuropathy. Of the 12 patients with ocular findings, 6 (50.0%) were born outside of the United States. Discussion: Ocular complications of HIV/AIDS are less common in children compared to adults. The prevalence of ocular disease in our referral cohort (33.3%) was consistent with other studies. Conclusions: Ocular complications of HIV/AIDS are uncommon in children infected with HIV.
159 A comparison of surgical outcomes in patients with unilateral cranial nerve VI palsy. Kimberly S. Merrill, Laura Lenius, Erick D. Bothun, Stephen P. Christiansen Introduction: A significant abduction deficit complicates surgical management of patients with CN VI palsy. We compared the outcomes of four surgical interventions in patients with unilateral CN VI palsy who had a 3 or greater abduction deficit: botulinum toxin (BTX-A) alone, horizontal surgery alone, vertical transposition alone, and vertical transposition plus BTX-A. Methods: With IRB approval, we performed a retrospective chart review for patients with unilateral CN VI palsy who had surgery between 1998 and 2013. Inclusion criteria were 3 or greater abduction deficit, stable preoperative alignment .6 months, and .6 months postoperative follow-up. Results: Of 82 patients with CN VI palsy, 26 met inclusion criteria. Mean duration of follow-up was 18 months (6-51 months). There
Journal of AAPOS
156 Parent experiences and perspectives on medical services for their children with albinism: a qualitative study. Kelly E. Lusk, Anne L. Corn, Terry L. Schwartz Introduction: For parents of children with visual impairments, including albinism, it is often difficult to navigate the array of medical services. The purpose of this study was to investigate experiences and perspectives of parents regarding their childrens medical care (specifically, but not limited to, pediatric ophthalmologists and primary eye care physicians) via guided focus groups. Methods: Parents of children with albinism were recruited through participation at the National Organization of Albinism and Hypopigmentation Conference in July 2014. Focus groups were conducted on four separate occasions during the conference. Results: Thirty-seven parents from across the U.S. and Canada participated in focus groups. Overall themes from the focus groups included knowledge level of albinism, coordination of services/interdisciplinary approach to services, referral practices regarding pediatric low vision services and local school systems, and expectations for future visual and independent functioning. Discussion: Parents had both positive and negative experiences/ perspectives regarding medical services. Many parents were not aware of some medical services/resources that other parents discussed. There are wide differences in parents statements about how medical services are provided to children with albinism. Conclusions: These data give insight into how families perceive experiences with medical professionals, including pediatric ophthalmologists. This information can aid pediatric ophthalmologists and their staff, in understanding how and why parents may be satisfied or dissatisfied with the care their children receive. A quantitative study is currently underway on this same topic to further investigate and provide additional guidance to pediatric ophthalmologists and other medical professionals regarding the care of patients with albinism.
157 Episodic excessive blinking in children. Yasmin P. Mali, John W. Simon, Imran A. Chaudhri, Jitka Zobal-Ratner, Gerard P. Barry Introduction: Many children present with excessive blinking. Categorization, associated conditions, and prognosis are controversial. Methods: All children with excessive blinking were reviewed, excluding those with known uveitis, glaucoma, or obvious eyelid abnormalities. Parents were telephoned for follow-up. Results: A total of 74 children (54 boys), aged 1 to 10 years (mean, 4.7), had excessive blinking for 3 days to 1.5 years (mean, 2.5 months). Parents were contacted in 55% of cases. In 26, parents could not identify a cause. In 2, Tourette syndrome was diagnosed, 1 following presentation. In 2, dexmethylphenidate (a stimulant used for ADHD) was suspected to be the cause. There was complete resolution in 29, some improvement
Volume 19 Number 4 / August 2015 in 8, and no improvement in 4 cases. No new ophthalmologic diagnoses were uncovered. Discussion: All children with excessive blinking should undergo ophthalmologic examination. Families should be encouraged to follow-up as needed for redness, light sensitivity, or other eye symptoms. If blinking persists, further evaluations can be coordinated with the pediatrician. Conclusions: Episodes of excessive blinking rarely indicate neurologic disorders and frequently resolve spontaneously.
158 Prevalence and clinical characteristics of ocular disease in children with HIV/AIDS. Taliva D. Martin, Maya S. Ling, Emmett T. Cunningham, Ann Petru, Susan H. Day Introduction: Describe the prevalence and clinical characteristics of ocular disease in children with HIV/ AIDS. Methods: Charts of patients less than 18 years old followed at the HIV/AIDS clinic at UCSF Benioff/ Childrens Hospital Oakland between March 2012 and May 2014 were reviewed. Patients who consented for the study underwent an eye examination by a pediatric ophthalmologist. Results: Charts of 50 patients were reviewed. Thirty-six (72%) underwent an eye examination, including 19 (52.8%) girls and 17 (47.2%) boys. Age at time of examination ranged from 3 to 17 years (mean, 11.4 years; median, 11.0 years). Mean and median CD4 count were 814.4 cells/microliter and 772.5 cells/microliter, respectively. In 31 patients (86.1%) visual acuity was 20/20 at final followup. Four patients (11.1%) had interpalpebral conjunctival injection, and 1 each (2.8%) had an accommodative esotropia, an intermittent exotropia, congenital ptosis, peripheral lattice degeneration, retinal scars from previous treatment of retinopathy of prematurity, hypopigmented retinal lesions, hyperpigmented retinal lesion, and HIVassociated retinal vasculitis and optic neuropathy. Of the 12 patients with ocular findings, 6 (50.0%) were born outside of the United States. Discussion: Ocular complications of HIV/AIDS are less common in children compared to adults. The prevalence of ocular disease in our referral cohort (33.3%) was consistent with other studies. Conclusions: Ocular complications of HIV/AIDS are uncommon in children infected with HIV.
159 A comparison of surgical outcomes in patients with unilateral cranial nerve VI palsy. Kimberly S. Merrill, Laura Lenius, Erick D. Bothun, Stephen P. Christiansen Introduction: A significant abduction deficit complicates surgical management of patients with CN VI palsy. We compared the outcomes of four surgical interventions in patients with unilateral CN VI palsy who had a 3 or greater abduction deficit: botulinum toxin (BTX-A) alone, horizontal surgery alone, vertical transposition alone, and vertical transposition plus BTX-A. Methods: With IRB approval, we performed a retrospective chart review for patients with unilateral CN VI palsy who had surgery between 1998 and 2013. Inclusion criteria were 3 or greater abduction deficit, stable preoperative alignment .6 months, and .6 months postoperative follow-up. Results: Of 82 patients with CN VI palsy, 26 met inclusion criteria. Mean duration of follow-up was 18 months (6-51 months). There
Journal of AAPOS