ABSTRACT
Ankyloblepharon filiforme adnatum (AFA) is a mild form of ankyloblepharon, in which there is partial thickness fusion of the central portion of the lid margins, sparing the canthi. Although it can be seen as an isolated sporadic congenital defect, it is important for pediatric ophthalmologists to be cognizant of its possible association with a number of anomalies. One infrequent, but nevertheless important association, is with trisomy 18. We present three cases of AFA in association with trisomy 18, and emphasize the need for clinicians to search for other abnormalities in a newborn presenting with AFA.
Subject(s)
Chromosomes, Human, Pair 18 , Eyelids/abnormalities , Trisomy , Adult , Eyelids/pathology , Female , Humans , Infant, Newborn , MaleABSTRACT
Many different sutures have been advocated for use in closing the corneoscleral incision during cataract surgery. We surveyed 354 North American pediatric ophthalmologists to find out the type of suture they use for pediatric cataract surgery and any associated complications. Of the sutures indicated in the 244 (69%) surveys returned, 10-0 nylon sutures were the most popular choice despite a relatively large number of related complications and the occasional need for general anesthesia to remove them.
Subject(s)
Cataract Extraction , Ophthalmology , Pediatrics , Sutures , Child , Cornea/surgery , Data Collection , Humans , North America , Nylons , Sclera/surgery , Sutures/adverse effectsABSTRACT
Strabismus is a common ocular abnormality in children and can have significant effects on visual, physical, and psychological development. The causes of ocular misalignment are numerous. Primary care physicians should be skilled in the evaluation of ocular motility in children. They also should understand the basic pathophysiology of common strabismus disorders and be able to identify those children at risk. This knowledge will aid in making a proper referral to an ophthalmologist when a strabismic disorder is suspected or detected.
Subject(s)
Strabismus/diagnosis , Strabismus/therapy , Child , Child, Preschool , Humans , Infant , Strabismus/etiology , Syndrome , Vision, Ocular/physiologyABSTRACT
Epiphora, or excess tearing, is a common problem in infants. The most frequent etiology of this disorder is a nasolacrimal duct obstruction. There are other conditions, however, some of which can be serious, which can cause tearing. Infections of the eyelids and conjunctiva, an undiscovered foreign body, and congenital glaucoma are among the conditions that must be ruled out when any child presents with excessive tearing.
Subject(s)
Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus Diseases/therapy , Child , Humans , Infant , Lacrimal Apparatus/anatomy & histology , Lacrimal Apparatus/physiology , Lacrimal Apparatus/physiopathology , Lacrimal Apparatus Diseases/physiopathology , Lacrimal Duct Obstruction/congenital , Lacrimal Duct Obstruction/therapy , Mucocele/congenital , Mucocele/therapyABSTRACT
We used a blunt irrigating cannula to infuse tetracaine 0.5% solution into the posterior sub-Tenon's space in 26 consecutive patients undergoing strabismus surgery under local anesthesia. All patients were sedated with combinations of fentanyl citrate and either propofol or midazolam. The results suggest that this technique is a safe and effective method of performing strabismus surgery under local anesthesia.
Subject(s)
Anesthesia, Local/methods , Strabismus/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Connective Tissue , Humans , Middle Aged , Orbit , Patient Satisfaction , Prospective Studies , Tetracaine/administration & dosageABSTRACT
We investigated the synthesis and degradation of collagen in lacerated rabbit corneas. The rate of collagen synthesis was measured by the incorporation and hydroxylation of [14C]proline up to 5 weeks after a penetrating laceration. Our results indicate that protein and collagen synthesis is initially reduced during the 24 h period after laceration and then increases in two phases. A moderate increase in protein and collagen synthesis occurs up to day 5 after laceration. Synthesis then decreases to a low level through the 10th day after injury. A second wave of increase in protein and collagen synthesis takes place reaching a new peak of approximately twice the activity as found in control corneas after 5 weeks of healing. Afterwards, the rate of protein and collagen synthesis declines and reaches the basal level after 7 weeks of healing. In a separate set of experiments, rabbit corneas were lacerated and allowed to heal for one or three weeks at which point 100 microCi of [14C]proline was injected into each anterior chamber. The corneas were excised 1 to 17 days later and subjected to collagen analysis. Our data indicates that the degradation of collagen synthesized by the cornea 1 week after laceration followed biphasic kinetics. In the first phase, the half-life of newly-synthesized collagen is 20 days, whereas it is approximately 4 days in the second phase. It is of particular interest that the accelerated degradation of the newly-synthesized [14C]collagen is concomitant with the increased rate of collagen synthesis during the wound healing process. The degradation of collagen synthesized 3 weeks after injury was slower and followed monophasic kinetics having a half-life of 14 days. The degradation of non-collagenous 14C-proteins follow a monophasic kinetics having a half-life of 6-7 days. Polyacrylamide gel electrophoresis of newly-synthesized collagen indicated that the collagen(I) and collagen(V) were the main collagenous components synthesized by the lacerated corneas.