Use of polymerase chain reaction (PCR) in the diagnosis of congenital toxoplasmosis.

Congenital toxoplasmosis (CT) is a parasitic disease that causes serious fetal and neonatal harm or death. In countries that do not have antenatal screening programs, the initiation of CT treatment relies on a postnatal diagnosis. Until recently, diagnosis was based on clinical signs and immunoglobulin seropositivity, which is fraught with difficulty. In these cases, diagnosis was often delayed or treatment, which carries risk, started empirically. We highlight the use of polymerase chain reaction to diagnose a case of congenital toxoplasmosis, allowing early treatment and justifying the treatment burden.

A worldwide survey of retinopathy of prematurity screening.

BACKGROUND: To ascertain which countries in the world have retinopathy of prematurity (ROP) screening programmes and guidelines and how these were developed. METHODS: An email database was created and requests were sent to ophthalmologists in 141 nations to complete an online survey on ROP screening in their country. RESULTS: Representatives from 92/141 (65%) countries responded. 78/92 (85%) have existing ROP screening programmes, and 68/78 (88%) have defined screening criteria. Some countries have limited screening and those areas which have no screening or for which there is inadequate knowledge are mainly Southeast Asia, Africa and some former Soviet states. DISCUSSION: With the increasing survival of premature babies in lower-middle-income and low-income countries, it is important to ensure that adequate ROP screening and treatment is in place. This information will help organisations focus their resources on those areas most in need.

Comparison of the Efficacy of Medial Rectus Recession and Lateral Rectus Resection for Treatment of Divergence Insufficiency.

PURPOSE: Surgical approaches for divergence insufficiency esotropia include medial rectus recession and lateral rectus resection. A retrospective chart review compared the efficacy of each. METHODS: Eighteen patients older than 50 years with divergence insufficiency esotropia who were operated on between 2005 and 2012 by two surgeons were reviewed. RESULTS: Nine patients underwent medial rectus recession and nine underwent lateral rectus resection. The average distance esotropia decreased from 19.75 to 3.2 prism diopters in the medial rectus recession group (P = .001) and from 17.7 to 2.6 prism diopters in the lateral rectus resection group (P = .0002). The disparity between distance and near alignment decreased from 7.3 to 3.4 in the medial rectus recession group (P = .019) and from 9 to 5.4 prism diopters in the lateral rectus resection group (P = .004). CONCLUSIONS: Both medial rectus recession and lateral rectus resection are effective treatment for divergence insufficiency, with both decreasing distance-near disparity.

Wide-field digital retinal imaging for retinopathy of prematurity screening in Australasia: a survey of practicing ophthalmologists.

PURPOSE: To compare retinopathy of prematurity (ROP) screening experiences using binocular indirect ophthalmoscopy (BIO) and wide-field digital retinal imaging (WFDRI) at centers in Auckland, New Zealand, with those of other centers in Australasia. METHODS: A web-based survey regarding methods of screening for ROP was distributed to ophthalmologists in Australia and New Zealand. RESULTS: Thirty-five ophthalmologists participated in the survey, of whom 30 participated in ROP screening. Sixteen respondents used BIO exclusively, 2 used WFDRI exclusively, and 12 used both. Of these, 3 respondents used WFDRI for remote screening. CONCLUSIONS: A significant proportion of ROP screeners have access to and are using WFDRI, but few currently use a telemedicine model for ROP screening.

Solutions in pediatric cataracts.

PURPOSE OF REVIEW: Modern pediatric cataract surgical techniques combined with a greater understanding of the natural history of aphakia and pseudophakia have changed the approach to the surgery of pediatric cataracts. RECENT FINDINGS: Advanced surgical techniques, new pharmacologic options and long-term refractive planning have improved surgical success. SUMMARY: It is essential that the ophthalmic surgeon who cares for children with cataracts is aware of these issues.