Prevalence of refractive errors in pediatric patients with retinoblastoma

Volume 20 Number 4 / August 2016 between posterior displacement and type of deviation was seen in 50% of the patients; no uniform relation was found between muscle insertion, intraoperative forced-duction-testing or time interval between surgeries. Discussion: Anatomical changes of the EOM insertion are common in patients with strabismus following SB procedures. Conclusions: Surgeons must be aware of potential anatomical changes when performing strabismus surgery following SB procedures. 173 Prevalence of refractive errors in pediatric patients with retinoblastoma. Victor M. Villegas, Hilda Capo, Craig A. McKeown, Timothy G. Murray Introduction: The main purpose of this study is to investigate refractive errors in children with retinoblastoma (RB). Methods: An institutional review board-approved retrospective cohort study was undertaken at an ocular oncology practice in Miami, FL. Subjects underwent examination under general anesthesia as part of their RB follow-up, which included evaluation by a single pediatric ophthalmologist from 2014 to 2015. Cycloplegic retinoscopy was performed and keratometry data was assessed with a hand-held Retinomax K-plus 3 kerato-refractometer (Righton Ophthalmic Instruments). Results: The study included 62 eyes of 37 subjects with 18 (51%) males and 19 (49%) females. Seventeen eyes (27%) had hyperopia with SE $3.00 D. Ninteen subjects (51%) had anisometropia $0.5 D; 8 (13%), anisometropia $2 D. Astigmatism $1 D was present in 54% of the eyes, and astigmatism $1.5 D was present in 29%. Mean steepest corneal axis was 91.9  34.0 . The mean difference between refractive cylinder and corneal cylinder was 1.1 D. Discussion: Large studies have validated that strabismus and refractive errors are significant risk factors for unilateral amblyopia. Mild astigmatism (1.0–2.0 D) has been associated with amblyopia in preschool children. However, refractive errors in children with RB have not been studied. In our study, a significant proportion of eyes had significant astigmatism and anisometropia. Conclusions: This study reports the high proportion of amblyogenic risk factors in children with RB, both in RB affected eyes and contralateral normal eyes. Significant experience in pediatric refraction and visual rehabilitation may help these children achieve maximal visual potential. 174 Feasiblility to monitor objective compliance with liquid crystal glasses intermittent occlusion therapy. Jingyun Wang, Daniel E. Neely, Kai Januschowski, Charlotte Schramm, David A. Plager Introduction: Amblyz liquid crystal glasses utilize an intermittent occlusion technique (at 30-second opaque/transparent intervals) and avoid adhesive to treat amblyopia, potentially improving compliance. Several pilot studies support the effectiveness of this new device making it an interesting option/alternative for amblyopia treatment. However, there are no objective compliance data for these glasses, limiting understanding of the dose-repsonse for this treatment. This study reports the feasibility of a sensor to monitor objective compliance with Amblyz glasses. Methods: Two children (6-7 years) with unilateral severe amblyopia associated with strabismus and anisometropia were enrolled. Prior to enrollment, both wore glasses for 12 weeks. At enrollment, both

Journal of AAPOS

e47 were prescribed 12 hours of intermittent occlusion therapy with Amblyz glasses. An inexpensive, commercially availabe sensor was attached to the temple arm to monitor compliance for 3 weeks. Compliance was defined as the percentage of hours of actual glasses wearing compared to the prescribed hours. Daily and general compliance were calculated. Results: Patient A had general compliance of 89%, but daily compliance declined to from 110% to 60% over 3 weeks; patient B had approximately 52% general compliance, with poor daily compliance on weekends. Neither of the patients parents reported that the child had discomfort or social concerns related to the attached sensor. Discussion: Objective compliance with Amblyz glasses can be monitored by a simple sensor. These preliminary results are limited by short-term follow-up. Conclusions: This finding will guide quantitatively investigate intermittent occlusion therapy in treating amblyopia. 175 Nonvitreoretinal abusive ocular trauma in children: a systematic review. Patrick Watts, Thomas Betts, Sartaj Ahmed, Sabine Maguire Introduction: To identify the spectrum of nonretinal ocular injuries due to child abuse. Methods: An all language search of MEDLINE, PsychINFO, EMBASE, AMED, Web of Science and CINAHL databases,1950-2015, was conducted. Inclusion criteria: explicit confirmation of aetiology, age \18 years, examination details as conducted by an ophthalmologist. Exclusion: Post-mortem data, organic diseases of the eye, review articles. Standardised critical appraisal and narrative synthesis was conducted. Results: A total of 1,492 studies identified; 152 full texts were assessed; and 49 underwent two independent reviews, resulting in 5 included studies: 3 case series and 2 case reports. The included cases (n 5 26) describe ocular, facial and skeletal injuries occurring as a consequence of child abuse. Ocular signs included periorbital oedema, chemosis, injection, abrasion, hyphema and cataract. Of interest all children that had suffered physical abuse with ocular injury had subconjunctival hemorrhages. Children presenting with ocular injuries from abuse had a mean age of 13.9 months (range, 1-68), whilst those who suffered violent corporal punishment were considerably older (mean, 96 months). All cases underwent screening for occult fractures, but confirmed neuroimaging in only 2/5 eligible cases. Those who had suffered corporal punishment underwent no further investigations. Discussion: The purpose of this systematic review was to identify the spectrum of non-retinal ocular abusive injuries and potentially highlight "red-flag" injures. Conclusions: Although the face is the most common site of abusive injury, there is a paucity of high-quality data on non-retinal ocular abusive injury. Subconjunctival hemorrhages are a potential sentinel injury of abuse, and warrant further evaluation. 176 Macular segmentation via optical coherence tomography in pediatric optic nerve head drusen and mild papilledema. James W. Weightman, Mays Antoine El-Dairi, Andrew Lee, Jared Duncan, CarlJoe Mehanna, Sharon Freedman Introduction: Optic nerve head drusen (ONHD) and papilledema in children can lead to partial optic atrophy, and frequently children