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PubMed2003

Ocular component data in schoolchildren as a function of age and gender.

PURPOSE: To describe the refractive error and ocular components of a large group of school-aged children as a function of age and gender. METHODS: In this report, we describe the refractive error and ocular components of 2583 school-aged children (49.3% girls, overall mean [+/-SD] age 10.0 +/- 2.3). Measurement methods included cycloplegic autorefraction, autokeratometry, videophakometry, and A-scan ultrasonography. For statistical comparisons across gender and age, a critical point of alpha = 0.005 was used to assess significance because of the large sample size and the large number of comparisons made. RESULTS: Of these 2583 children, 10.1% were myopic (-0.75 D or more myopia in both meridians), and 8.6% were hyperopic (+1.25 D or more hyperopia in both meridians). As would be expected, there was a significant effect of age on refractive error (spherical equivalent, p < 0.0001), toward less hyperopia/more myopia. There was no significant difference in the average refractive error between girls and boys (p = 0.0192). Girls had steeper corneas than boys (0.74 D steeper in the vertical meridian and 0.63 D steeper in the horizontal meridian, p < 0.0001). There were no significant differences in corneal power with age (p = 0.16). Both older age and male gender were significantly associated with deeper anterior chambers (p < 0.0001 for both). The crystalline lens showed significant thinning with age (p < 0.0001), however, there was no significant difference in the lens thickness between girls and boys (p = 0.66). Both Gullstrand lens power and calculated lens power showed significant effects of age and gender (p < 0.0001 for both). Girls, on average, had Gullstrand lens powers that were 0.28 D steeper and calculated lens powers that were 0.80 D more powerful than boys. Axial length also showed significant effects of age and gender (p < 0.0001 for both). Girls' eyes were, on average, 0.32 mm shorter than those of boys. CONCLUSIONS: These cross-sectional data show a general pattern of ocular growth, no change in corneal power, and crystalline lens thinning and flattening between the ages of 6 and 14 years. Girls tended to have steeper corneas, stronger crystalline lenses, and shorter eyes compared with boys.

Adolescent↗
PubMed2003

Prevalence of myopia among 12- to 13-year-old schoolchildren in northern Mexico.

PURPOSE: The aim of this article was to report the prevalence of refractive errors, mainly myopia, among 12- to 13-year-old children in a metropolitan setting in Mexico. METHODS: A total of 1035 schoolchildren were examined in a field study in Monterrey, Mexico. The examination included best-corrected visual acuity and refraction during cycloplegia. A sample of the children was sent to a pediatric eye clinic and underwent cycloplegic refraction with an autorefractor. RESULTS: We found a prevalence of myopia (>/=-0.5 D SE) of 44%, whereas bilateral myopia was present in 37% of the children. In the total sample, high myopia (>/=-5D) was found in 1.4%. The prevalence of myopia was significantly higher in girls. Only 20% of children with bilateral myopia used prescription glasses; 8% had prescribed glasses, but did not use them. Hyperopia (>/=+1 D) was present in 6.0% of the total population, and astigmatism (>/=-1.5 D) was present in 9.5%. CONCLUSIONS: The prevalence of myopia among 12- to 13-year-old children in Mexico is high. The majority of cases are low grade, and a large number of the myopic children do not have, or do not use, prescription glasses.

Adolescent↗
PubMed2003

Continuous ambient lighting and lens compensation in infant monkeys.

PURPOSE: Protracted daily lighting cycles do not promote abnormal ocular enlargement in infant monkeys as they do in a variety of avian species. However, observations in humans suggest that ambient lighting at night may reduce the efficiency of the emmetropization process in primates. To test this idea, we investigated the ability of infant monkeys reared with continuous light to compensate for optically imposed changes in refractive error. METHODS: Beginning at about 3 weeks of age, a hyperopic or myopic anisometropia was imposed on 12 infant rhesus monkeys by securing either a -3 D or +3 D lenses in front of one eye and a zero-powered lens in front of the fellow eye. Six of these monkeys were reared with the normal vivarium lights on continuously, whereas the other six lens-reared monkeys were maintained on a 12-h-light/12-h-dark lighting cycle. The ocular effects of the lens-rearing procedures were assessed periodically during the treatment period by cycloplegic retinoscopy, keratometry, and A-scan ultrasonography. RESULTS: Five of six animals in each of the lighting groups demonstrated clear evidence for compensating anisometropic growth. In both lighting groups, eyes that experienced optically imposed hyperopic defocus (-3 D lenses) exhibited faster axial growth rates and became more myopic than their fellow eyes. In contrast, eyes treated with +3 D lenses showed relatively slower axial growth rates and developed more hyperopic refractive errors. The average amount of compensating anisometropia (continuous light, 1.6 +/- 0.5 D vs. control, 2.3 +/- 0.5 D), the structural basis for the refractive errors, and the ability to recover from the induced refractive errors were also not altered by continuous light exposure. CONCLUSION: Ambient lighting at night does not appear to overtly compromise the functional integrity of the vision-dependent mechanisms that regulate emmetropization in higher primates.

Animals↗
PubMed2003

Agreement between Scheimpflug photography and A-scan ultrasonography in anterior segment ocular measurements in children.

PURPOSE: The Scheimpflug principle, as a method of performing biometry on the anterior segment, has not been widely used in the clinical setting compared with ultrasonography. The purpose of this study was to examine the agreement in anterior chamber length and lens thickness measurements between A-scan ultrasonography and Scheimpflug photography. METHODS: A total of 252 children aged between 6 and 12 years participated in this study. All subjects had instillation of cycloplegic eye drops before measurement. Scheimpflug photography and A-scan ultrasonography were performed in this sequence on the same day. The anterior segment length on the Scheimpflug images was taken as the axial corneal thickness added to the anterior chamber depth. A-scan ultrasonography was performed by placing the probe on the corneas after topical anesthesia. Differences were obtained by subtracting the A-scan ultrasonography measurements from the Scheimpflug measurements. Data were analyzed using difference vs. mean plots. RESULTS: For anterior chamber length, the mean difference between the two methods was -0.03 +/- 0.16 mm, with 95% limits of agreement of -0.35 to +0.30 mm. However, Scheimpflug readings were greater than that of ultrasonography for smaller measurements, and the opposite was true for larger measurements. For lens thickness, the mean difference was -0.2 +/- 0.10 mm, with 95% limits of agreement of -0.40 to +0.00 mm. For the measurement of lens thickness, adding a correction factor of 0.2 mm to Scheimpflug's readings should replace that of A-scan readings reasonably well. CONCLUSIONS: The readings obtained from these two methods of biometry must be used with the knowledge of the instruments. We discuss the possible reasons for the difference in readings obtained using these two instruments.

Anterior Eye Segment↗
PubMed2004

The Nepal longitudinal study: predicting myopia from the rate of increase in vitreous chamber depth.

Biometric data on 897 Tibetan children living in Kathmandu, Nepal were collected over the period 1992 to 2000 with regular visits every 2 years. Measurements included cycloplegic autorefraction, A-scan ultrasonography, and video phakometry. Children who had not been studied at least once at age 12 years or older were not included in these analyses. The other subjects were divided into two groups; myopic if the refractive error was ever <-0.50 D, and emmetropic/hyperopic if the refractive error was never <-0.50 D, the nonmyopic group. Using all children who had been examined with four or five observations over time, the change of vitreous chamber depth with age by group was determined using a mixed-model regression method. The increase in vitreous length was 0.070 mm/year for the emmetropic group and 0.165 mm/year for the myopic group, with the differences apparent before the onset of myopia. An independent group of 59 children in whom there were two vitreous chamber depth measures before the age of 12 years and one measure taken after 12 years of age were used to assess the rate of increase in vitreous chamber depth as a predictor of myopia. Two other methods were examined using the independent group; the ratio of axial length to corneal radius of curvature and refractive error at age 10 years. Predictors based on rate of increase in vitreous chamber depth and axial length/corneal radius of curvature had sensitivities of 75% and 45%, respectively, and refractive error at age 10 years as a predictor for those who will not become myopic had a sensitivity of 88%.

Adolescent↗
PubMed2004

Accuracy of noncycloplegic autorefraction in school-age children in China.

PURPOSE: To evaluate the accuracy of noncycloplegic autorefraction in a representative sample of school-age children in China. METHODS: Refractive error was measured with an autorefractor, both before and after cycloplegia induced with cyclopentolate, in a population-based sample of 4973 children between the ages of 7 and 18 years. Spherical equivalent refractive error and astigmatism as represented by Jackson crossed-cylinders (J0 and J45) were the main outcome measures. RESULTS: Noncycloplegic measurements of equivalent spheres were consistently more negative or less positive than those after cycloplegia, with mean +/- SD differences of -1.23 +/- 0.97 D. The differences were particularly large for hyperopic eyes (mean difference of -2.98 +/- 1.65 D for hyperopia of at least +2.00 D) while becoming progressively smaller for emmetropic eyes, and smaller yet for myopic eyes (mean difference of -0.41 +/- 0.46 D for myopia of -2.00 D or more). Increasing age was associated with increased, but clinically insignificant, differences. Little difference was found between noncycloplegic and cycloplegic measurements of astigmatism: mean J0 and J45 differences were -0.08 +/- 0.13 D and -0.01 +/- 0.09 D, respectively. CONCLUSIONS: Noncycloplegic autorefraction was found to be highly inaccurate in school-age children and, thus, not suitable for studies of refractive error or for prescription of glasses in this population.

Adolescent↗
PubMed2004

Prevalence of myopia in a group of Hong Kong microscopists.

PURPOSE: To study the prevalence and magnitude of myopia in a group of Hong Kong Chinese microscopists and compare it with that observed in microscopists working in the United Kingdom. METHODS: Forty-seven microscopists (36 women and 11 men) with a median age of 31 years and working in hospital laboratories throughout Hong Kong were recruited to the study. Information about past refractive corrections, microscopy work, and visual symptoms associated with microscope use were collected. All subjects had a comprehensive eye examination at The Hong Kong Polytechnic University Optometry Clinic, including measures of refractive error (both noncycloplegic and cycloplegic), binocular vision functions, and axial length. RESULTS: The prevalence of myopia in this group of microscopists was 87%, the mean (+/- SD) refractive error was -4.45 +/- 3.03 D and mean axial length was 25.13 +/- 1.52 mm. No correlation was found between refractive error and years spent working as a microscopist or number of hours per day spent performing microscopy. Subjects reporting myopia progression (N = 22) did not differ from the refractively stable group (N = 19) in terms of their microscopy working history, working hours, tonic accommodation level, or near phoria. However, the AC/A ratio of the progressing group was significantly greater than that of the stable group (4.59 delta/D cf. 3.34 delta/D). CONCLUSION: The myopia prevalence of Hong Kong Chinese microscopists was higher than that of microscopists in the United Kingdom (87% cf. 71%), as well as the Hong Kong general population (87% cf. 70%). The average amount of myopia was also higher in the Hong Kong Chinese microscopists than the Hong Kong general population (-4.45 D cf. -3.00 D). We have confirmed that the microscopy task may slightly exacerbate myopia development in Chinese people.

Adult↗
PubMed2004

Corneal and lenticular components of total astigmatism in a preschool sample.

PURPOSE: To examine the contribution of corneal and lenticular components to total astigmatism in preschool low and high astigmats to determine whether there was any compensation for high astigmatism by the lenticular component. METHODS: Cycloplegic refractive and keratometric measures using the Retinomax K-Plus (Nikon Inc., Melville, NY) were conducted on 129 children (mean age, 51.1 +/- 8.4 mo) in Oxford County, Canada. We divided the sample into high astigmats (total cylinder > or =1 D; mean, 1.38 +/- 0.43 D; n = 29) and normal astigmats (total cylinder < or =0.75 D; mean, 0.22 +/- 0.20 D; n = 100). Measures of total and corneal cylinder were transposed into J0 and J45 components, where positive and negative J0 values quantified with-the-rule (WTR) and against-the-rule astigmatisms, respectively, and J45 quantified oblique astigmatism. RESULTS: WTR astigmatism was dominant in both the high and normal astigmatic group. J0 and J45 components of corneal astigmatism were highly correlated with total astigmatism in high astigmats, whereas only J0 was significantly correlated with total astigmatism in normal astigmats. Although the magnitude of total and corneal cylinder was significantly greater in high astigmats, overall lenticular cylinder was similar in both groups. However, the Fourier transforms showed high astigmats to have significantly lower lenticular J0 and higher lenticular J45 than the normal astigmats. CONCLUSIONS: Astigmatism in 3- to 5-year-old children is primarily corneal. In preschool children, the lens does not vary in response to high amounts of corneal WTR astigmatism, and in fact, it increases the oblique astigmatism component when the corneal component is high. In high astigmats, lenticular astigmatism contributes to both J0 and J45 components, whereas the corneal contribution is primarily J0.

Astigmatism↗
PubMed2004

Refractive astigmatism and the toricity of ocular components in human infants.

PURPOSE: Many studies have characterized astigmatism in infancy, but few have been longitudinal or contained ocular component data. This study characterized the frequency, orientation, and longitudinal change with age of infant astigmatism. Additional factors investigated were the influence of early astigmatism on emmetropization and its relation to corneal and lenticular toricity. METHODS: Three hundred two infants were enrolled in the study. Of these, 298 provided data for at least one visit at 3 +/- 1 months, 9 +/- 1 months, 18 +/- 2 months, and 36 +/- 3 months. Testing included cycloplegic retinoscopy (cyclopentolate 1%), video-based keratophakometry, and ultrasonography over the closed eyelid. RESULTS: Astigmatism > or =1.00 DC was common at 3 months of age (41.6%) but decreased in prevalence to 4.1% by 36 months (p < 0.0001). The most common orientation was with-the-rule at 3 months (37.0% compared with 2.7% for against-the-rule) but against-the-rule at 36 months (3.2% compared with 0.9% for with-the-rule). Most of the change in the average value of the horizontal/vertical component of astigmatism (J0) occurred between 3 and 9 months (-0.26 +/- 0.36 D; p < 0.0001) with no significant change between 9 and 36 months (-0.05 +/- 0.36 D; p=0.09). Spherical equivalent refractive error was not correlated with J0 at 3 and 9 months (R=0.002, p=0.48 and R=0.001, p=0.56, respectively). The two were only weakly correlated at 18 and 36 months (R=0.06 for each age, p <0.0001, p=0.0002, respectively). Changes in spherical equivalent between 3 and 9 months were unrelated to either the initial value of J0 (partial R for J0=0.0001; p=0.85) or the change in J0 (partial R for change in J0=0.0031; p=0.31). Across all the ages, corneal toricity was with-the-rule, and lenticular toricity was against-the-rule (produced by the toricity of the posterior lens surface). The cornea and anterior lens surface became more spherical with age, contributing to the shift away from with-the-rule refractive astigmatism. Toricity of all the refractive surfaces became less variable with age. CONCLUSIONS: Consistent with many reports, astigmatism was common in early infancy but decreased in prevalence with age, particularly when with-the-rule in orientation. The reduction in percentage of infants with astigmatism appeared to be caused by decreases in the toricity of the cornea and the anterior lens combined with decreases in the variability of corneal and lenticular surfaces. Astigmatism in infancy appeared to be unrelated to emmetropization of spherical equivalent refractive error.

Age Distribution↗
PubMedDate not supplied

Treating myopia with acoustic biofeedback: a prospective study on the evolution of visual acuity and psychological distress.

OBJECTIVE: The effects of a visual training technique on changes in myopia, visual acuity, and psychological distress were studied in a controlled prospective study. METHOD: A group of 33 female students with myopia < or = 3.50 diopters (D) underwent visual training using an acoustic biofeedback technique. A group of 22 female students with myopia and a group of 27 students with emmetropia formed the two control groups, matched for school, age, sex, and refractive error. Manifest and cycloplegic refraction, visual acuity, personality profile (CPI), and psychological distress (SCL-90) were measured at the baseline (T0), at 10 weeks (T1), and after 12 months (T2). RESULTS: At T2, myopia significantly progressed both in the treated and in the untreated students with myopia. Visual acuity improved only in the treated myopia group (despite refraction objectively being worse). No differences were found among the personality profiles in the three groups. All items indicative of psychological suffering improved in the group treated for myopia whose visual acuity was ameliorated. CONCLUSIONS: The visual training technique led to no improvement in objective measures of visual acuity, but did lead to an improvement in one relatively subjective measure of visual acuity and a parallel improvement in psychological conditions. The students with myopia who were treated consequently had a greater sense of general well-being.

Accommodation, Ocular↗
PubMed2002

Spasm of accommodation associated with closed head trauma.

Spasm of accommodation, creating pseudomyopia, is generally associated with miosis and excess convergence as part of spasm of the near reflex. It may also exist as an isolated entity, usually attributed to psychogenic causes. We present six cases of accommodative spasm associated with closed head injury. All patients were male, ranging in age between 16 and 37 years. The degree of pseudomyopia, defined as the difference between manifest and cycloplegic refraction, was 1.5 to 2 diopters. A 3-year trial of pharmacologically induced cycloplegia in one patient did not lead to reversal of the spasm when the cycloplegia was stopped. All patients required the manifest refraction to see clearly at distance. The pseudomyopia endured for at least 7 years following head trauma. This phenomenon may represent traumatic activation or disinhibition of putative brain stem accommodation centers in young individuals.

Accommodation, Ocular↗
PubMed1998

Comitant strabismus.

Proprioceptive receptors have long been known anatomically to be present in extraocular muscles, specifically at the myotendinous junction. Their function in regulating smooth pursuits is experimentally demonstrated. The clinical significance of this for strabismus is still unknown. Esotropia surgery before resolution of moderate amblyopia is not detrimental. Botulinum toxin injections will correct infantile esotropia but require more anesthesia sessions overall than does conventional surgery, increasing cost. Late-onset comitant esotropia is usually refractive in nature and rarely neurologic. Comitant esodeviation is also prevalent in children with known neurologic insults. In both situations, it is the associated neurologic signs that point to the underlying neurologic cause. Posterior fixation suture will correct a high accommodative convergence/accommodation ratio esotropia. Exotropia negatively affects patients' quality of life. Surgical outcomes differ in patients whose angle of deviation increases with 1 hour of occlusion testing at extreme distances ("outdoor sensitivity"). Recession resection influences the distance and near angles of deviation equally whereas bilateral lateral rectus resection influences the distance deviation more than the near. Spray administration of cycloplegic agents to closed eyelids has been shown to be as effective as administration of eye drops. The spray is much better tolerated by patients and easier to administer. Photorefraction, although not yet effective as a screening tool, is useful to document alignment and refractive errors.

Administration, Topical↗
PubMed2001

Effects of anti-inflammatory drugs following cataract extraction.

Cycloplegics, corticosteroids, and nonsteroidal anti-inflammatory drugs have been applied in the treatment of postoperative inflammation following cataract extraction. Of these, topical preparations of nonsteroidal anti-inflammatory drugs, such as ketorolac tromethamine 0.5% and diclofenac sodium 0.1%, offer comparable efficacy to corticosteroids in the reduction of postoperative inflammation, and offer lower risks of adverse events in most patients. Comparative studies of these drugs from the past 5 years are highlighted.

Anti-Inflammatory Agents↗
PubMed2004

Syphilitic interstitial keratitis: treatment with immunosuppressive drug combination therapy.

OBJECTIVE: The following is a case presentation of congenital syphilitic keratitis in a boy 6 years of age who was successfully treated with an immunosuppressive drug combination therapy. METHODS: Congenital syphilitic keratitis was diagnosed by clinical findings and laboratory tests. The child was unresponsive to traditional treatment; thus, systemic immunosuppressive therapy, which consisted of oral cyclosporine 4 mg/kg/d, 6 days per week, and oral low-dose steroids (fluocortolone 0.8 mg/kg a week, given every other day), was initiated. RESULTS: Corneal disease showed great improvement with this therapy, with progressive healing of lesions in the first month of treatment and no signs of toxic renal, hepatic, or growth abnormalities. Recurrences of uveitis have not occurred, and corneal interstitial keratitis episodes have been limited to 3 in an 8-year period. After 6 months with no recurrences, a tapering off of the systemic therapy was initiated, and the child is still asymptomatic and without flare-ups. CONCLUSIONS: Congenital syphilitic keratitis is usually treated with topical steroids and cycloplegic drugs, which not only can be ineffective but can also lead to complications such as cataract and glaucoma. In the present case report, a pediatric patient affected by syphilitic interstitial keratitis was treated successfully with an immunosuppressive drug combination therapy.

Child↗
PubMed2005

Airbag-induced bilateral corneal graft dehiscence.

PURPOSE: To report a case of bilateral corneal graft dehiscence caused by blunt trauma. METHODS: Case report of bilateral simultaneous corneal graft dehiscence with expulsion of the lens and iris as a result of airbag-induced trauma. RESULTS: Both corneal buttons were resutured, the prolapsed iris tissue was repositioned in the right eye, and anterior vitrectomy was performed bilaterally. Topical and systemic antibiotics, topical steroids, cycloplegic agents, and antiglaucoma drugs were initiated. Repeated B-scan ultrasound examinations demonstrated an attached retina in both eyes. Three weeks after admission, the right eye was reoperated for removal of remnant lens material and additional anterior vitrectomy. The patient was fitted with polycarbonate spectacles with an optical correction of +8 in both eyes. Visual acuity improved to 20/200 and 0.5/60 in the right and left eyes, respectively. The right corneal graft regained transparency, but the left one remained hazy. CONCLUSION: Airbag deployment during motor vehicle collisions is a significant cause of ocular morbidity. The reported risk of airbag-related eye injury is 2.5% for any eye injury and 0.4% for severe eye injury. Patients undergoing corneal surgery should be counseled about the weakness of the donor-recipient interface and should consider wearing protective glasses.

Accidents, Traffic↗
PubMed2006

Efficacy of nonsimultaneous bilateral LASIK after nonsimultaneous bilateral penetrating keratoplasty.

PURPOSE: To show if nonsimultaneous bilateral laser in situ keratomileusis (LASIK) is a safe and effective procedure for patients with bilateral penetrating keratoplasty (PKP). METHODS: Five patients (10 eyes), with keratoconus, underwent PKP separately in each eye. After an average PKP follow-up of 45.8 months per eye, (range, 19-92 months), each eye underwent 1-stage LASIK using the Visx Star S3 laser to correct its residual refractive error. We used the cycloplegic refraction as the target for the LASIK surgery. Each patient had his or her eyes done separately 3 weeks apart. RESULTS: Pre-LASIK myopia averaged -3.93 +/- 2.9 D, ranging from -10.00 to +0.75 D. Pre-LASIK astigmatism averaged -3.25 +/- 0.80 D, ranging from -1.75 to -4.50 D. Mean pre-LASIK keratometry was 45.4 +/- 2.6, ranging from 42.2 to 50.5. Uncorrected visual acuity pre-LASIK averaged 20/220, ranging from 20/60 to 20/400. Best-corrected spectacle visual acuity (BCSVA) pre-LASIK averaged 20/22, ranging from 20/20 to 20/30. Nine eyes had no complications. One eye had a flap buttonhole during LASIK, and surgery was aborted. No vision was lost in this eye. Mean follow-up after LASIK in the 9 eyes was 17 +/- 15.2 months, (range, 4-56 months). Mean post-LASIK ametropia in these 9 eyes was +0.25 +/- 0.45 D, ranging from -0.50 to +0.75 D. Average post-LASIK astigmatism was -0.33 +/- 0.38 D, ranging from 0 to -0.75 D. In the 9 treated eyes, uncorrected vision post-LASIK averaged 20/25, ranging from 20/20 to 20/30. BCSVA post-LASIK averaged 20/21, ranging from 20/20 to 20/25. No lines of visual acuity were lost in any of the eyes. CONCLUSION: Young patients who have had bilateral PKP, with good postoperative vision and low levels of myopia, astigmatism, and minimal wound override, are good candidates for bilateral nonsimultaneous LASIK. Further studies can now be done on the performance of bilateral simultaneous LASIK in patients who have had corneal transplant surgery in both of their eyes.

Adult↗
PubMed2004

Choroiditis, pigment epithelial detachment, and cystoid macular edema as complications of poststreptococcal syndrome.

PURPOSE: Two cases of poststreptococcal uveitis are presented. One patient developed nongranulomatous anterior uveitis (case 1). A second patient developed nongranulomatous anterior uveitis followed by granulomatous uveitis with concurrent choroiditis, retinal pigment epithelial detachment, and cystoid macular edema (case 2). Current concepts regarding the pathogenesis of poststreptococcal syndrome and its ocular sequelae are also discussed. CASE REPORTS: Case 1: A 31-year-old female patient presented with bilateral nongranulomatous uveitis after a recent onset of sore throat. A past diagnosis of rheumatic fever was revealed during acquisition of the patient's history. Blood chemistry analysis indicated elevated anti-streptolysin O antibody titers as the only significant elevated result. Case 2: A 33-year-old female presented initially with bilateral nongranulomatous uveitis. A history of recurrent sore throat was reported. Blood chemistry analysis revealed elevated anti-streptolysin O antibody titers only. "Mutton fat" keratic precipitates eventually developed; however, the bilateral uveitis resolved after topical cycloplegic and corticosteroid treatment. An anterior granulomatous uveitis with concurrent choroiditis, retinal pigment epithelial detachment, and cystoid macular edema ensued during a recurrent episode. Blood chemistry analysis was unremarkable at that time. CONCLUSIONS: : Anterior nongranulomatous/granulomatous and posterior uveitis should be considered clinical manifestations of poststreptococcal syndrome in patients with a clinical history and/or serological evidence indicating possible past streptococcal infection. A variation of host-genetic-predisposed immune response, the patient's human leukocyte antigen haplotype, pathogen virulence, and/or deposition location of immune circulating complexes may give rise to the diverse spectrum of clinical ocular sequelae in poststreptococcal syndrome. Poststreptococcal uveitis may comprise a similar immunologic pathogenesis to that of acute rheumatic fever, acute glomerulonephritis, and other autoimmune diseases.

Adult↗
PubMed2004

Normal eye growth in emmetropic schoolchildren.

PURPOSE: The purpose of this report is to describe the normal growth pattern of the optical components of the eye in a cohort of emmetropic, school-aged children. METHODS: Emmetropia was defined as refractive error (measured by cycloplegic autorefraction) in the vertical and horizontal meridians of the right eye between +1.00 D and -0.25 D at all the visits. This definition resulted in a sample of 194 children enrolled in the Orinda Longitudinal Study of Myopia (OLSM) between ages 6 and 14 years with at least 2 years of follow-up evaluation (across three annual visits) between 1989 and 2000. The optical components measured included corneal power, anterior chamber depth, crystalline lens thickness, Gullstrand lens power, calculated lens power, crystalline lens index, vitreous chamber depth, and axial length. RESULTS: Corneal power and anterior chamber depth were best modeled as quadratic functions of ln (age). The model involving the square of the inverse of age best described calculated lens power and crystalline lens index. The relationship between age and crystalline lens thickness was best described using a linear function of age with a point of inflection. A linear function of ln (age) with a point of inflection best described the relationship between age and axial length, Gullstrand lens power, and vitreous chamber depth. For five of the eight components (crystalline lens thickness, Gullstrand lens power, calculated lens power, corneal power, and crystalline lens index), the line modeling the data was negative in overall direction, indicating that the component value decreased with age. The upward trend of the line modeling axial length, anterior chamber depth, and vitreous chamber depth reflected the continued growth of the eye from age 6 years to age 15 years. CONCLUSIONS: A picture of normal eye growth in emmetropes from ages 6 to 15 years is provided based on a combination of cross-sectional and longitudinal data. Axial elongation, crystalline lens flattening and thinning, and decrease in lens power are its hallmarks.

Adolescent↗