Adduction deficiency following medial recti recession in Duane's retraction syndrome. Case report.
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Duane Retraction Syndrome↗
Biomedical subjects
W N Clarke
Publications and source records attributed to W N Clarke.
Sodium citrate in paediatric outpatients.
To determine whether the gastric content pH of paediatric patients could be raised in an effort to decrease post-aspiration morbidity and mortality, the antacid sodium citrate (0.4 ml.kg-1) was given preoperatively to 25 patients aged 1 to 14 (6.0 +/- 3.5, mean +/- SD) years. Their gastric content pH was measured following induction of anaesthesia. These values were compared to those obtained from a control group (n = 20) ranging in age from seven months to nine (3.3 +/- 2.7) years. A gastric content pH value of greater than 2.5 was measured in 23 of the 25 patients who received sodium citrate. There were only two patients in the control group with a gastric content pH greater than 2.5, p less than 0.001, Fisher exact test. Only one child refused to take the medication. The administration of sodium citrate appears to be an effective method of raising the gastric content pH in paediatric patients.
Ambulatory Care↗
Traumatic hyphema in children.
The authors reviewed the medical records of 316 children admitted between January 1977 and March 1985 with a diagnosis of traumatic hyphema. In this group of patients, 1 to 17 years old treated without antifibrinolytics, the incidence of secondary hemorrhage was 7.6% (24 of 316 patients) of whom three required surgical evacuation of the clot. The risk of rebleeding did not correlate with the patient's age, use of topical steroids, or cycloplegics. Of 176 patients followed from 1 month to 7 years post-hospital discharge, 91% achieved 20/30 vision or better, but only 77% of the patients with secondary hemorrhage attained this level of vision. Amblyopia, a potential threat in young children, occurred in only two children both of whom also required cataract extraction. From our captive pediatric population of 228,000 the incidence of traumatic hyphema is 17 per 100,000 children per year.
Adolescent↗
Check ligaments: surgical effects in infantile esotropia.
In a prospective randomized study, we compared the results of surgical treatment of 25 patients with infantile esotropia, using bilateral medial rectus muscle recession of a graded amount without severing the check ligaments, to results obtained with a similar group of 23 patients in whom check ligaments were severed at the time of bimedial surgery. No significant difference could be found in the immediate postoperative and 6-month postoperative ocular alignment of the two groups.
Axis, Cervical Vertebra↗
The oculocardiac reflex during ophthalmoscopy in premature infants.
Of 54 consecutive infants referred for ophthalmoscopy with the pupils dilated, continuous electrocardiographic monitoring showed that 17 (31%) had bradycardia, ranging from 10% to 59% of baseline, coincident with instillation of eyedrops, insertion of an eyelid speculum, pressure on the globe, or stretching of the medial and lateral recti muscles.
Arrhythmias, Cardiac↗
Depression in adduction syndrome.
Three cases of depression in adduction syndrome are described. All occurred unilaterally, in the left eye, in boys and were characterized by depression and retraction of the involved eye with attempted adduction. This was accompanied by an inability to elevate the eye in adduction and a markedly abnormal head posture. Surgery, consisting of superior oblique tenotomy and recession of the lateral rectus muscle, did not allow the ocular rotation to improve but did allow the anomalous head posture to be corrected. The homogeneity of the clinical appearance and the lack of response to surgery suggests that this is a distinct clinical entity.
Child↗
Ocular involvement in varicella.
Twenty-four children with classical chickenpox were referred for ophthalmic assessment because of lesions on the lids and in the eye. The appearance of these lesions, their treatment, and their complications are discussed. Twenty-five percent of these children were documented to have an anterior uveitis.
Anti-Bacterial Agents↗
Corneal pathology and aniridia associated with partial trisomy 2q, due to a maternal (2;6) translocation.
A newborn with partial trisomy 2q, due to a maternal (2;6) translocation is presented. The baby had microcephaly, a prominent forehead, hypertelorism, a broad nose with a flat nasal bridge, a long philtrum, micrognathia, and low set ears which are common to cases with partial 2q trisomy. Additional findings of aniridia and marked corneal pathology are reported.
Chromosomes, Human, 1-3↗
Detection of drusen of the optic disc in children by B-scan ultrasonography.
Distinguishing between anomalous elevation of the optic disc caused by buried drusen and true papilledema can often be clinically difficult. In a prospective study of 18 children with drusen of the optic disc B-scan ultrasonography with a lowered sensitivity was found to be useful in the uncooperative child. A rational approach to the investigation of elevation of the optic disc in children is offered.
Adolescent↗
Brown's syndrome: fusion status and amblyopia.
Many children with Brown's superior oblique tendon sheath syndrome do not have full fusion and stereopsis. Of 28 such patients 8 failed to demonstrate orthophoria in their assumed head position, and many continued to have a head tilt with one or the other eye patched. All eight showed an appropriate vertical deviation, but in addition six showed esotropia and two exotropia. The lack of fusion in their assumed head position led to amblyopia in seven patients.
Amblyopia↗
Self-inflicted ocular injuries in children.
Ocular damage resulting from self-mutilation is not uncommon in severely retarded children. Such injuries are caused by repeated headbanging or self-inflicted blows to the face. We treated four children with self-inflicted ocular injuries ranging from corneal lacerations to vitreous hemorrhage and retinal detachment. One child, a 14-year-old boy with tuberous sclerosis, became blind. Persons caring for such children should be alert to changes in the appearance of the pupil, changes in the personality or performance level of the child, and to the development of exotropia. Early treatment and protective equipment (spectacles or helmets) may prevent permanent injury.
Adolescent↗
Vanishing infantile esotropia.
Three cases of large-angle infantile esotropia are presented. Over a minimum follow-up period of 37 months the angle of esotropia decreased spontaneously to less than 10 prism diopters without surgery or the use of glasses, and recognized late complications of infantile esotropia developed: bilateral overaction of the inferior oblique muscle in three cases, and latent nystagmus and dissociated vertical deviation in two cases each. The significance of these findings is discussed.
Child, Preschool↗
Surgical results in intermittent exotropia.
Among 78 children who had undergone surgery for intermittent exotropia, undercorrection was found in 39, an acceptable result in 33 and overcorrection in 6. A review conducted to determine what factors might explain the high frequency of undercorrection showed that the average age of the patients was higher than usual, and this was a significant prognostic factor. The presence or absence of associated hypertropias, lateral incomitance and A or V patterns was not of prognostic importance. Purposeful overcorrection of the exodeviation by 10 to 15 prism diopters tended to ensure a more satisfactory result.
Adolescent↗
Periorbital and orbital cellulitis in childhood.
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Adolescent↗
Amblyopia and the monofixation syndrome.
Children with a Monofixation syndrome often show a small angle constant esotropia with an overlying esophoria of variable and often large angle. Commonly the phoria is well controlled unless the child is very tired, or the eyes are dissociated. Treatment of a concomitant amblyopia by patching may result in an inability to control the phoria, with breakdown of the strabismic angle to a large esotropia. Illustrative cases are presented.
Amblyopia↗
[Organization of a psychiatry service for children and adolescents].
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Adolescent↗
Ocular complications of lightning.
A 17-year-old female suffered first and second degree facial burns due to a lightning bolt. Retinal stria were noted 48 hours after the accident and a retinal pigment epithelial defect was documented on the third day. A dense posterior subcapsular cataract was present by the 14th week.
Adolescent↗
Lacrimal hypersecretion in children.
To the differential diagnosis of epiphora in children we propose to add paroxysmal lacrimal hypersecretion. While certainly not a new entity, it should be considered in a child who is tearing intermittently without mattering or evidence of infection. Recognition of this problem may prevent anesthetic morbidity or unnecessary instrumentation of the nasolacrimal apparatus.
Attention↗