Bilateral tonic pupils secondary to anti-GD2 antibody therapy for neuroblastoma.

We report the case of a 12-year-old girl with stage 4 neuroblastoma who developed tonic pupils secondary to immunotherapy with dinutuximab, an anti-GD2 antibody, based on the timeline provided by her mother with regard to onset of symptoms. The patient presented with difficulty reading and chronic dilated pupils bilaterally, according to her mother's observations over 6 months prior to presentation. Testing with dilute pilocarpine supported our presumption of tonic pupils.

The role of informational videos in parental education concerning retinopathy of prematurity examinations.

PURPOSE: To assess the effectiveness of educational videos in improving parental experience and understanding of the retinopathy of prematurity (ROP) examination and the importance of timely follow-up. METHODS: A prospective nonrandomized study was conducted with the parents of 142 patients who received ROP examinations. The analysis compared two groups of parents. Parents in the video group viewed two educational videos about the ROP examination created at our institution that explained the purpose and importance of the examination and timely follow-up. The second (control) group only received standard print materials on ROP examinations. Surveys evaluating parent satisfaction, preparedness, and understanding of follow-up were administered to all participating parents at their first outpatient appointment. The χ2 and t tests were used to determine differences between the groups. RESULTS: Parents in the video group were more likely to state that the ophthalmologist spoke to them regarding results of the eye examination (P = 0.027), report that staff explained how the examination would be performed (P = 0.003), report being very satisfied (P = 0.011), and demonstrate increased knowledge of the necessity of the examinations (P = 0.018) compared with the print-only group. CONCLUSIONS: In our study cohort, use of educational videos increased parental knowledge, preparedness, and satisfaction.

Cardiopulmonary arrest following administration of Cyclomydril eyedrops for outpatient retinopathy of prematurity screening.

Eyedrops used for mydriasis and cycloplegia can be systemically absorbed, causing serious side effects, including oxygen desaturation, apnea, bradycardia, transient hypertension, delayed gastric emptying, and transient paralytic ileus. These effects can be more serious in infants because of their lower body mass and immature cardiovascular and nervous systems. We report a case of a 27-week-old infant who suffered a cardiopulmonary arrest after the administration of only Cyclomydril eyedrops (Alcon Laboratories, Fort Worth, TX) during an outpatient retinopathy of prematurity examination.

Incidence of retinal hemorrhages in abusive head trauma.

PURPOSE: To evaluate whether a relationship exists between the presence of retinal hemorrhages and confessions and/or identified perpetrators in cases of abusive head trauma. METHODS: A retrospective chart review was conducted of all abusive head trauma cases. All cases that met criteria for abusive head trauma were placed into one of three categories: perpetrator confessed (category A), perpetrator identified without confession (category B), and no perpetrator identified (category C). RESULTS: Forty-eight cases met the criteria for abusive head trauma, with 18, 16, and 14 cases in categories A, B, and C, respectively. Retinal hemorrhages were identified in 16 of 18 (88%) cases in category A, 12 of 16 (75%) in category B, and 6 of 14 (43%) in category C. A statistically significant difference regarding the presence of retinal hemorrhages was seen for perpetrator identified (28 of 34 or 82%) compared to no perpetrator identified (6 of 14 or 43%) (P = .034). The difference in retinal hemorrhages was correlated to the higher incidence of acute presentation in the perpetrator identified group (31 of 34 or 91%) compared to that in the perpetrator not identified group (9 of 14 or 64%) (P = .023). CONCLUSION: The incidence of retinal hemorrhages in abusive head trauma for identified perpetrators, regardless of a confession, is similar. However, there is a statistically significant decrease in the incidence of retinal hemorrhages in abusive head trauma when comparing identified perpetrators to non-identified perpetrators. This decreased incidence of retinal hemorrhages was statistically correlated to a lower incidence of acute presentation in victims of abusive head trauma without an identified perpetrator.[J Pediatr Ophthalmol Strabismus 2013;50(3):169-172.].

Primary follicular lymphoma of the conjunctiva in a 6-year-old child.

Primary follicular lymphomas arise in the lymph nodes or spleen or in extranodal sites. Ocular adnexal tumors are rare. We report the case of a 6-year-old boy with a 3-mm conjunctival mass. The lesion was resected with clean surgical margins. The child has been closely monitored and has remained cancer free for 3 years.