Appendix 1: Prescribing Practices for Refractive Errors in Pediatric Patients

Home , Aniseikonia, Infantile esotropia, Pediatric ophthalmology

Virginia Miraldi Utz

This appendix serves as a guideline for prescribing glasses in contrast, school-age children may beneﬁ t from correction isoametropic patients (based on specialist experience, of low levels of myopia to meet visual demands of school Table A1.1 ), anisometropic patients (Table A1.2 ), and auto- activities’ viewing (see Chap. 4 on Myopia). mated screening guidelines (Table A1.3 ). Table A1.4 lists the 2. The prescription must be based on cycloplegic refraction. refractive risk factors for amblyopia. There are several eye drop regimens utilized depending Prescribing practices are based on specialist experience on age and iris pigmentation: with the following considerations: • < 6 months of age: one drop OU of cyclopentolate 0.5 % and phenylephrine 2.5 %. 1. Assessing visual needs according to the child’s age: • 6 months to 12 years: 1 % cyclopentolate. • Children have high accommodation amplitudes, and • > 13 years: 1 % tropicamide and 2.5 % phenylephrine. therefore, mild to moderate hypermetropia does not • Patients with dark eyes may require two sets of drops require correction in the absence of signs such as eso- 5 min apart. tropia or asthenopic or visual symptoms (see Chap. 3 3. Whenever possible, the cycloplegic refraction should be on Hypermetropia). subjectively manifested to ensure that vision improves. • Infants and very young children are most interested in For example, a small change in axis in a patient with high objects at an arm’s length up to 2 m from them, and astigmatism may greatly improve the visual acuity and therefore, low levels of myopia are easily tolerated. In hence the quality of vision for the patient.

Table A1.1 Practice patterns generated by consensus for prescribing refractive correction <1 year 1–2 years 2–4 years 4–7 years Miller and Harvey [1 ]a Myopia −4.50a −3.00a −2.00 a Hypermetropia +5.50a +5.00a +4.50 a Astigmatism +3.00a +2.50a +2.00 a AAO PPP [2 ] Myopia ≥−5.00 ≥−4.00 ≥−3.00 No speciﬁ c numbers, Hypermetropia ≥+6.00 ≥+5.00 ≥+4.50 prescribe based on symptoms Hypermetropia/ET ≥+2.50 ≥+2.00 ≥+1.50 Astigmatism ≥+3.00 ≥+2.50 ≥+2.00 aNumbers based on 75 % (majority) of American Association for Pediatric Ophthalmology and Strabismus (AAPOS) members would prescribe glasses. AAO American Academy of Ophthalmology, PPP Preferred Practice Patterns

V. Miraldi Utz, MD Abrahamson Pediatric Eye Institute, Cincinnati Children’s Hospital Medical Center , 3333 Burnet Ave, MLC 4008 , Cincinnati , OH 45229-3039 , USA Department of Ophthalmology , University of Cincinnati College of Medicine , 3333 Burnet Ave, MLC 4008 , Cincinnati , OH 45229-3039 , USA

© Springer Science+Business Media, LLC 2016 769 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 770 Appendix 1: Prescribing Practices for Refractive Errors in Pediatric Patients

Table A1.2 American Academy of Ophthalmology Preferred Practice Table A1.4 Refractive amblyogenic risk factors [4 ] Patterns for treating patients with anisometropia without strabismus [ 2 ] Anisometropia (spherical or cylindrical): >1.5 D <1 year 1–2 years 2–3 years Hyperopia > 3.5 D in any meridian ≥ Myopia −4.00 −3.00 −3.00 Myopia > 3.00 D in any meridian Hypermetropia +2.50 +2.00 +1.50 Astigmatism > 1.5 D at 90 or 180 Astigmatism 2.50 2.00 2.00 Oblique astigmatism > 1.0 (>10° eccentric to 90° or 180°)

Table A1.3 American Association for Pediatric Ophthalmology and Strabismus Vision Screening Committee Guidelines for automated preschool screening of refractive error [3 ] 12–30 months 31–48 months ≥49 months Hypermetropia ≥+4.50 ≥+4.00 ≥+3.50 Astigmatism ≥+2.00 ≥+2.00 ≥+1.50 Anisometropia ≥+2.50 ≥+2.00 ≥+1.50 Appendix 2: Strategies for the Child Who Would Not Wear Glasses

Sarah L. Lopper

In this appendix, we explore possible causes of intolerance to • Step 4. Note power of best focus; the least plus/most- glasses. We will look for possible errors related to the pre- minus set of lines is the sphere and the difference in power scription, the manufacturing of the lenses, or the fi t of the strength until the next set of lines is in focus is the amount frame. We will also consider issues related to behavior or of cylinder (astigmatism) in the lens if you are document- intolerance to foreign objects on the child’s face. Finally we ing in plus-cylinder format. will explore errors related to the initial examination and orig- inal prescription. Clinical Skill: Lens Transposition from Plus to Minus Cylinder • Step 1. Add the sphere and cylinder together to get the I. The Prescription Is Not Accurate or There Is new spherical power. an Optical Problem with the Lenses • Step 2. Change the sign of the cylinder (+ becomes − and − becomes +); do not change the amount of the cylinder. 1. Step 1: Examine the optics of the glasses. • Step 3. Change the axis by 90°. • Verify that the lenses were made as prescribed: Optical • Example 1: +3.25 + 2.50 × 135 in plus cylinder format labs grind lenses in minus cylinder format, and it is becomes +5.75−2.50 × 045 in minus cylinder format. possible that the glasses prescription was transposed • Example 2: +3.25−2.50 × 135 in minus cylinder format incorrectly if it was written in plus cylinder format. becomes +0.75 + 2.50 × 045 in plus cylinder format. • Use a lensometer to measure the glasses prescription and confi rm it was made as prescribed. 2. Step 2: Verify that the lens is well centered in front of the child’s visual axis. Clinical Skill: Nonautomated Lensometry • The optical center of the lens is the point on the principle • Step 1. Place the lens on the lensometer. Secure after fi nd- axis of the lens through which light passes undeviated, ing the intersection of both sets of lines, and place this in and this should be aligned with the patient’s visual axis. the center of the lensometer eyepiece view. • The optical center of the lens can be measured and • Step 2. Turn the power wheel back and forth to focus each marked with a lensometer. Find the intersection of the set of lines. If both sets of lines are in focus at the same two sets of lines in the center of the lensometer eye- time (the single thicker lines and the set of three striped piece view, and use the self-recoiling lens marker to lines), then there is no cylinder present and the lens is make a dot on the lens center. spherical power only. • Place the glasses on the patient and determine if the • Step 3. If each set of lines is best focused at a different posi- mark matches the center of their pupils. If there is sig- tion on the power wheel, then there is cylinder present to nifi cant horizontal or vertical displacement, the child correct for astigmatism. Focus each set separately, and may not be seeing well because of an induced pris- adjust/determine the axis so the lines are exactly straight. matic effect, especially in higher prescriptions. – Prentice’s law applies to the amount of induced prism: P = dF where P is the prism power in Δ, d is dis- S. L. Lopper, O.D. Department of Ophthalmology, University of Cincinnati College of placement in centimeters, and F is the refracting Medicine, 3333 Burnet Ave , Cincinnati , OH , USA power of the lens

© Springer Science+Business Media, LLC 2016 771 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 772 Appendix 2: Strategies for the Child Who Would Not Wear Glasses

3. Step 3: Consider distortions related to polycarbonate pantoscopic tilt is approximately 10° (±5°). This is taken material: into account when the frame is fi tted. For every 2° of • The Abbe value (range 20–60) describes the amount of pantoscopic tilt, the optical center is lowered 1 mm [6 ]. chromatic aberration of lens materials and is intrinsic Companies make tools to measure pantoscopic tilt, or to the specifi c refractive index of the lens material [5 ]. you can simply use a protractor. Place the vertical Lower Abbe values have more aberrations (spherical straight edge of the protractor parallel to the fl oor. aberration, coma, marginal astigmatism, curvature of The pantoscopic tilt is the angle that is made fi eld, and distortion) and are most pronounced with between the lens and the temple when the 90° mark increasing distances from the center of the lens. is aligned with the temple. Aberrations are more signifi cant in higher plus or – Face form: the wrap of the frame around the face. If minus lenses. there is too much face form or unequal face form for – Polycarbonate has an Abbe value of 30. the right and left lenses, the patient will not be looking – CR-39 and Crown glass have Abbe values of 58. through the optical center of the lens and the vertex distance is affected. 4. Step 4: Consider a defect in or an inappropriate base • Poorly fi tting frames: curve of the lens. – Frames that are too tight on a child’s cheeks or those • Measure base curve of the lenses with a lens clock. that pinch behind their ears will not be comfortable. They should be no steeper than 7 diopters or fl atter – Nose pads that are not adjusted appropriately or miss- than 4 diopters in two primary meridians 90° apart. ing will be uncomfortable. • Lower number = fl atter base curve and higher number = steeper base curve. • Patients may prefer their “old” glasses with a different III. Behavioral Issues base curve than the “new” glasses. Matching previous base curve can help. • Behavioral problems of the child may limit success with glasses. 5. Step 5: Consider aniseikonia in patients with signifi cant • Sometimes children just do not like the color or style of anisometropia. their frames anymore or they do not want to wear them • This can be corrected with base curve adjustments or anymore due to peer pressure from classmates. contact lenses. • In addition, some patients with Down syndrome or pediatric patients with sensory integration disorders such as autism spectrum disorder may have diffi culty adjusting to II. The Glasses Are Not Manufactured Well or glasses. Are Not Fitting Well • Discuss with a co-managing occupational therapist to see if the glasses can be integrated into their therapy session • When glasses are fi tted, several measurements are taken or look for additional strategies that might increase to ensure a proper fi t. If there are deviations from these compliance. initial fi tting measurements, the effective power of the lenses may change and affect visual acuity, or the child may complain of asthenopia. IV. There Is a Change in the Child’s – Vertex distance: The posterior surface of lenses should Refraction, a Binocular Vision Disorder, or generally be 12–15 mm from the corneal plane. This a New or Previously Undetected Eye becomes especially signifi cant when lens power is Problem above 5–6 diopters. • Repeat the cycloplegic refraction and subjectively mani- Increasing vertex Makes a “plus” lens Makes a “minus” lens fest if the patient is able. distance more “plus” less “minus” • Consider cycloplegic eye drops to help the child adjust/ Decreasing vertex Makes a “plus” lens Makes a “minus” lens accept the hyperopic correction. distance less “plus” more “minus” • Rule out a binocular vision disorder or accommodative dysfunction. – Pantoscopic tilt: The angle of tilt of the lower rim of the • Perform a dilated eye exam to rule out ocular health glasses frame toward the cheek. A normal amount of changes. Appendix 3: Prescribing Prisms for Pediatric Patients

Sarah L. Lopper

(6) Larger amounts of prism add to lens thickness and Goals of Prismatic Correction weight, cause image distortions, and give the lens a poor appearance. Smaller lens, eye size, high index lens mate- • Restore binocularity and/or fusion rial, antirefl ective coating, and lens edge treatments can • Relieve or eliminate diplopia all improve prism lens appearance [ 8 ]. As a general • Alleviate abnormal head position guideline, 1Δ adds 1 mm of lens thickness [9 ]. • Relieve asthenopic symptoms (7) Fresnel prism is available up to 40Δ, but prisms larger than 8–10Δ start having a poorer optical quality and will cause increased refl ections and a decrease in visual acu- Steps for Determining and Prescribing ity and contrast sensitivity. Use on the non-dominant Prismatic Correction (Table A3.2 ) eye, Fresnel lenses change color over time. (8) Sector Fresnel prism can be applied to just a portion of (1) Always correct refractive error fi rst. Perform a cyclople- the lens (e.g., “A” or “V” pattern deviations, non- gic refraction with subjective manifest whenever comitant strabismus, hemianopic visual fi eld loss). possible. (9) Consider prism in the following cases (Table A3.1 ): (2) Prismatic correction is best tolerated with smaller angle • Blow out fracture (Fresnel) and comitant strabismus. • Nystagmus (place null point in primary position) (3) Perform a prism adaptation trial for 20–30 min. • After retinal surgery (if small-angle strabismus and/ (4) Demonstrate effectiveness fi rst with Fresnel prism prior or anisometropia with diplopia) to grinding into the lens. • Sixth nerve palsy (adjusting Fresnel prism as angle (5) If there is both a vertical and a horizontal deviation, changes) determine fi rst if the vertical deviation is the primary or • Thyroid disease [10 ] (Table A3.2 ) secondary deviation. If it is the primary deviation, address the vertical deviation fi rst.

S. L. Lopper, O.D. Department of Ophthalmology , University of Cincinnati College of Medicine, 3333 Burnet Ave , Cincinnati , OH 45299 , USA

© Springer Science+Business Media, LLC 2016 773 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 774 Appendix 3: Prescribing Prisms for Pediatric Patients

Table A3.1 Indications for prismatic correction in pediatric patients Table A3.2 Approach to prismatic correction for horizontal and vertical deviations Short-term • To prevent symptoms and/or maintain indications binocularity while awaiting surgical Type of deviation Prescribed prism intervention Horizontal EXO: BI prism • Options: Ground-in • Nystagmus with head turn (e.g., to rotate deviation ESO: BO prism prism, Fresnel prism null position to primary) • BI in front of either eye Long-term • Surgical intervention is not a viable for EXO deviation indications option (patient is medically unstable) • BO in front of either eye • Awaiting resolution of a cranial nerve for ESO deviation palsy • Split the prism if above • Evolving deviation (e.g., thyroid disease) 3Δ • Incomitant strabismus to move area of • Ground prism best if single vision straight ahead ≤10Δ per lens • Homonymous hemianopia • Trial of prismatic • Surgical correction unpredictable (e.g., correction and phorias, divergence insuffi ciency, small confi rmation of fusion vertical deviations) may be utilized in older Contraindications, • Large stable comitant strabismus children prism is not helpful/ • Signifi cant incomitant strabismus Vertical Left hyper- • Options: Ground-in less helpful • Dragged foveal diplopia syndrome deviation deviation: BU OD, prism, Fresnel prism, BD OS slab-off prism (if vertical Right hyper- disparity distance/near), deviation: BU OS, lens decentration (helpful BD OD in moderate- to high- powered lenses only, use Prentice’s rulea ), contact lenses (small amounts, only vertical prism) • BD in front of hyper-eye • Split the prism between the eyes if above 3Δ • Ground prism best if ≤10Δ per lens • Superior oblique palsy, DVD, Brown syndrome, inferior oblique paresis BI base in, BO base out, BU base up, BD base down a Prentice’s rule: P = dF where P is the prism power in Δ, d is displacement in centimeters, and F is the refracting power of the lens Appendix 4: Pathogens and Medications for Infectious Conjunctivitis in Children

Alison E. Smith

As discussed in Chap. 9, Pediatric Conjunctivitis, bacterial atric infectious disease specialist. For other forms of pediat- and viral infections cause most infectious causes of conjunc- ric conjunctivitis, the most common etiologic agents are tivitis. Patients who present within the ﬁ rst month of life listed in Table A4.1 . Depending on pathogen, pharmacologic with conjunctivitis, termed ophthalmia neonatorum, have treatment can be catered accordingly to etiologic agent speciﬁ c pathogens associated (Table A4.1 ) and require (Table A4.2 ). In most cases of suspected bacterial etiology, urgent ophthalmologic and systemic evaluation and treat- empiric treatment is started with broad-spectrum coverage ment (Tables A4.2 and A4.3 ). Although the medications pre- (Table A4.2 ). Unlike bacterial etiologies, viral etiologies sented in these tables serve as a general guide, cases of usually require supportive care as discussed in Chap. 9 ophthalmia neonatorum should be co-managed with a pedi- (Pediatric Conjunctivitis).

Table A4.1 Common bacterial and viral pathogens associated with Table A4.2 Medications, dosages, and classifi cation of topical and conjunctivitis in children systemic therapy for bacterial conjunctivitis Bacterial conjunctivitis Staphylococcus aureus Trade Class of Streptococcus pneumonia Generic name name Dosing antibiotics Haemophilus infl uenzae Erythromycin 4–6 times daily Macrolide Moraxella catarrhalis Trimethoprim and Polytrim 4–6 times daily Ophthalmia neonatorum Neisseria gonorrhoeae polymyxin B (neonatal conjunctivitis) Chlamydia trachomatis Tobramycin drops Tobrex 4–6 times daily Macrolide Herpes simplex or ointment Viral conjunctivitis Adenovirus Zymaxid Zymar 4–6 times daily Fluoroquinolone Herpes simplex (usually keratoconjunctivitis) Erythromycin Romycin 4–6 times daily Macrolide Enterovirus (usually hemorrhagic) Gentamicin drops Gentak 4–6 times daily Macrolide Coxsackievirus (usually hemorrhagic) or ointment Varicella zoster Azithromycin Azasite Day 1 two Macrolide Picornavirus (oral) a doses then once daily for 5 days Levofl oxacin 4 times daily Fluoroquinolone Besifl oxacin Besivance 4 times daily Ciprofl oxacin Ciloxan 4 times daily Fluoroquinolone Gatifl oxacin 4 times daily Ofl oxacin Ocufl ox 4 times daily Fluoroquinolone Moxifl oxacin Vigamox/ 4 times daily Fluoroquinolone Moxeza a Oral medication dosages should be adjusted for age, and if in doubt, consult a pediatric infectious disease specialist.

A. E. Smith, M.D. Greenville Hospital System, University of South Carolina School of Medicine-Greenville, 220 Patewood Dr. , Greenville , SC 29615 , USA

© Springer Science+Business Media, LLC 2016 775 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 776 Appendix 4: Pathogens and Medications for Infectious Conjunctivitis in Children

Table A4.3 Medications and dosages utilized in ophthalmic neonatorum (neonatal conjunctivitis) Generic name Dosing Mechanism of action Ceftriaxone IM or IV 25–50 mg/kg once Cephalosporin (3rd generation) Cefotaxime IV 1 g q 8 h for at least 7 days Cephalosporin (3rd generation) Erythromycin PO 50 mg/kg/day q 6 h/14 days Macrolide Azithromycin PO, IV 20 mg/kg qd for 3 days Macrolide Appendix 5: Medications Commonly Used in Allergic Conjunctivitis Treatment

Alison E. Smith

The following medications are utilized in cases of allergic severe allergic conjunctivitis, topical steroids may be uti- conjunctivitis (Table A5.1 ). Most patients should be treated lized adjunctively while awaiting the efﬁ cacy of the H1 with an H1 -antagonist ± mast cell stabilizer, and families antagonist/mast cell stabilizer or for breakthrough symptoms should be educated that medications are for symptom pro- while on these medications. Cyclosporine may be utilized as phylaxis and take 1–2 weeks to be fully effective. In cases of well for steroid-sparing therapy in severe cases.

Table A5.1 Medications and dosages of medications utilized to treat allergic conjunctivitis Generic name Trade name Dosing Mechanism of action

Olopatadine Pataday/Pazeo Once daily H1 antagonist/mast cell stabilizer Patanol Twice daily Ketotifen Zaditor Twice daily Azelastine hydrochloride 0.05 % Alaway Twice daily Optivar Twice daily Prednisolone 1 % Pred Forte 4–6 times daily Corticosteroid Omnipred Fluorometholone 0.1 % FML Forte 4–6 times daily Corticosteroid Flarex FML Liquiﬁ lm Loteprednol 0.2 % Lotemax 4–6 times daily Corticosteroid Alrex Rimexolone 1 % Vexol 4–6 times daily Corticosteroid Restasis Cyclosporine 2 times daily Calcineurin inhibitor

A. E. Smith, M.D. Greenville Hospital System, University of South Carolina School of Medicine-Greenville, 220 Patewood Dr. , Greenville , SC 29615 , USA

© Springer Science+Business Media, LLC 2016 777 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 Appendix 6: IOL Power Selection for Children

Rupal H. Trivedi and M. Edward Wilson

R. H. Trivedi, M.D. • M. E. Wilson, M.D. Department of Ophthalmology, Miles Center for Pediatric Ophthalmology, Storm Eye Institute, Medical University of South Carolina, 167 Ashley Avenue, MSC 676 , Charleston , SC 29425-6760 , USA

© Springer Science+Business Media, LLC 2016 779 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 780 Appendix 6: IOL Power Selection for Children

Fig. A6.1 This algorithm (Fig. A6.1 ) is utilized by the authors to deter- ered. Figure A6.1 has been modifi ed and refi ned based on surgical mine intraocular lens power to be implanted based on age at the time of results of the authors [Table modifi ed from: Trivedi, RH, Wilson, ME, surgery. Factors such as status of the contralateral eye, presence or Ophthalmic Pearls: Selecting Intraocular Lens Power in Children. absence of amblyopia, and familial refractive error need to be consid- EyeNet Magazine, January 2006] Appendix 7: Measuring Axial Eye Length in Children

Fadia AlKhawaldeh

In order to determine the correct power for an intraocular terms so the child understands. Then instruct the patient to lens implant, it is necessary to obtain axial eye length (AEL) place his or her chin in the chin rest and focus on the central and keratometric measurements on the patient. The tech- light. Playing games such as “statue” and staring contests nique for obtaining these measurements varies depending on help the child focus and make the test less intimidating. This the age of the child and his or her physical ability to cooper- not only ensures a more a more accurate measurement but ate during testing. the full cooperation of the child as well. For most children under the age of 6 or 7 years, a sedated immersion technique performed in the operating room prior to surgery or during a sedated eye exam is best. For children Sedated Immersion A-Scan over the age of 7, the ultrasonographer is able to use his/her best judgment to assess the child’s ability to cooperate and to For infants, children under 7 years of age, and those who are follow instructions. If the child is cooperative and able to combative or unable to follow directions, a sedated immer- follow directions, the instrument of choice is the IOL Master® sion A-scan is necessary in order to obtain the axial eye for accurate AEL and keratometric readings. If the child is length and keratometric measurements required for IOL cal- uncooperative, combative, or unable to comprehend or fol- culations. This procedure is typically performed under full low verbal instructions, a sedated immersion technique is anesthesia in an operating room environment. preferred. Once the child has been fully inducted and sedated, the ultrasonographer begins by using a handheld keratometer to obtain corneal keratometric measurements for each eye. In Using IOL Master® for Axial Eye Length order to ensure consistency and accuracy, three separate Measurements readings should be taken. Once the keratometric readings are obtained, a plastic scleral shell measuring between 16 and When attempting to measure AEL on a child, it’s important 20 mm is placed directly on the eye and ﬁ lled with sterile to ensure that the child understands fully what is about to saline solution. The saline solution acts as a medium for the take place. This will help alleviate any anxiety they may be A-scan sound waves to travel through. Next, the ultrasonog- experiencing due to the impending test, in addition to ensur- rapher engages the machine using the foot pedal and obtains ing their best cooperation and efforts are put forth. To begin the requisite axial eye length measurements. Again, a mini- with, the ultrasonographer should explain to the patient and mum of three should be obtained to ensure accuracy. The his or her parent/guardian what they are about to do in simple procedure is repeated for the fellow eye, thus ensuring all measurements and calculations are complete for future surgical procedures when necessary. Additionally, this allows F. AlKhawaldeh, M.B.A., C.O.T., R.O.U.B. Department of Refractive Surgery, Cole Eye Institute, the ultrasonographer and surgeon to assess for any anatomi- Cleveland Clinic, 9500 Euclid Avenue, Suite i-21 , Cleveland , cal differences between the eyes and adjust the calculations OH 44195 , USA and treatments accordingly.

© Springer Science+Business Media, LLC 2016 781 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 782 Appendix 7: Measuring Axial Eye Length in Children

At this point, the axial eye length measurements are com- eye to allow for better sound wave penetration, and the ultra- plete, and the physician is able to determine the necessary sonographer will conduct a full sweep of the eye in all four lens power needed for the IOL implant (see Appendix 6). quadrants and at the cardinal positions of 12, 3, 6, and 9 If the surgeon’s view of the retina is obstructed due to the o’clock. If any abnormal ﬁ ndings are observed, they are density of the cataract, he or she may request a B-scan to be reported and their location is documented and addressed by performed at the same time. If a B-scan is required, the ultra- the surgeon accordingly. sonographer will then switch from the A-scan probe to the larger B-scan probe. A gel is used as a coupling agent on the Appendix 8: Surgical Instrumentation in Strabismus Surgery

Elias I. Traboulsi

Each surgeon has his/her preference for instruments to use shape and sharpness. Cross-action scissors and needle hold- for strabismus surgery. The accompanying photograph ers need to be released before storage in carrying trays to (Fig. A8.1 ) shows a tray with commonly utilized instruments maintain their straightness and rebound fl exibility. Fine- that are suffi cient for the performance of most strabismus needle holders should not be used with large needles. For procedures. A number of modifi ed hooks and other types of example, the fi ne/very fi ne-needle holder shown in the illus- needle holders, speculums, and forceps can be selected by tration should not be used to hold needles large than 6-0 the individual surgeon. gauge. This allows the jaws to hold smaller needles fi rmly, Proper cleaning and storage of instruments is critical. facilitating suture passage in tissues without wobbling. Tips of instruments need to be protected to maintain their

Fig. A8.1 Basic set of strabismus instruments. (1) Barbie retractor, (2) (14) pair of locking 0.5 Castroviejo forceps, (15) 0.3 Castroviejo for- Desmarres retractor, (3) Green muscle hook, (4) curved Stevens small ceps, (16) fi ne/very fi ne locking needle holder with fl at handles. The fl at muscle hook, (5) straight Stevens small muscle hook, (6) Jameson mus- handle facilitates the passage of long scleral passes by allowing a push- cle hook, (7) Jameson muscle hook, (8) Graefe muscle hook, (9) small ing rather than the rotating motion imparted by needle holders with a straight clamp used for muscle resections, (10) calipers, (11) bipolar round handle. (17) Heavy locking needle holder for 4-0 silk traction cautery, (12) large Helveston lid speculum, (13) Blunt Westcott scissors, sutures and (18) balanced salt solution with cannula

E. I. Traboulsi, M.D., M.Ed. Cleveland Clinic, Cole Eye Institute, 9500 Euclid Avenue, i-32 , Cleveland , OH 44195 , USA

© Springer Science+Business Media, LLC 2016 783 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 Appendix 9: Surgical Planning and Numbers

Virginia Miraldi Utz and Elias I. Traboulsi

The following tables are based on the numbers recommended 2. Monocular Surgery by Marshall M. Parks, M.D., and modiﬁ ed by many [11 , 12 ]. While they have been used to plan pediatric and adult cases, Medial rectus recession Lateral rectus resection it is unclear if they have been derived from cases performed 15 PD = 3.0 mm 3.5 mm in either or both groups. We do not address the issue of oper- 20 PD = 3.5 mm 4.0 mm 25 PD = 4.0 mm 5.0 mm ating on three horizontal muscles to treat large-angle devia- 30 PD = 4.5 mm 5.5 mm tions. We prefer operating on two muscles and addressing 35 PD = 5.0 mm 6.0 mm the residual deviation, if any, afterward using the two unop- 40 PD = 5.5 mm 6.5 mm erated horizontal muscles. We do not address the topic of 50 PD = 6.0 mm 7.0 mm 60 PD = 6.5 mm 7.5 mm adjustable suture use in this appendix. 70 PD = 7.0 mm 8.0 mm

Horizontal Strabismus Surgery Exotropia Esotropia 1. Binocular Surgery 1. Binocular Surgery Lateral rectus recession Medial rectus resectiona Medial rectus recession Lateral rectus resectiona 15 PD = 4.0 mm 15 PD = 3.0 mm 15 PD = 3.0 mm 15 PD = 3.5 mm 20 PD = 5.0 mm 20 PD = 4.0 mm 20 PD = 3.5 mm 20 PD = 4.5 mm 25 PD = 6.0 mm 25 PD = 5.0 mm 25 PD = 4.0 mm 25 PD = 5.5 mm 30 PD = 7.0 mm 30 PD = 5.5 mm 30 PD = 4.5 mm 30 PD = 6.0 mm 35 PD = 7.5 mm 35 PD = 6.0 mm b 35 PD = 5.0 mm 35 PD = 6.5 mm 40 PD = 8.0 mm 40 PD = 6.5 mm b 40 PD = 5.5 mm 40 PD = 7.0 mm 50 PD = 9.0 mm 50 PD = 6.0 mm 50 PD = 8.0 mm a If a large lateral rectus recession has been performed (≥9.0 mm) and 60 PD = 6.5 mm bilateral medial rectus resection is planned for residual exotropia, the 70 PD = 7.0 mm amount of resection may need to be reduced. b aIf a large medial rectus recession has been performed (>6.0 mm) and Recessions greater than 9.0 mm may result in an abduction deﬁ cit. In bilateral lateral rectus resection is planned for residual esotropia, the these cases, the surgeon might consider a staged approach (bilateral numbers for the resection of the lateral recti need to be reduced lateral rectus recession followed by bilateral medial resection if residual exotropia is still present).

V. Miraldi Utz, M.D. Abrahamson Pediatric Eye Institute, Cincinnati Children’s Hospital Medical Center , 3333 Burnet Ave, MLC 4008 , Cincinnati , OH 45229-3039 , USA Department of Ophthalmology , University of Cincinnati E. I. Traboulsi, M.D. College of Medicine, 3333 Burnet Ave, MLC 4008 , Cleveland Clinic, Cole Eye Institute , 9500 Euclid Avenue, i-32 , Cincinnati , OH 45229-3039 , USA Cleveland , OH 44195 , USA

© Springer Science+Business Media, LLC 2016 785 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 786 Appendix 9: Surgical Planning and Numbers

2. Monocular Surgery Face Turn to the LEFT (Right Gaze Preference)

Lateral rectus recession Medial rectus resection 1. Goal: To move eyes to the LEFT 15 PD = 4.0 mm 3.0 mm 20 PD = 5.0 mm 4.0 mm Degrees of face turn <20° 30° 45° 25 PD = 6.0 mm 4.5 mm Right eye: recess LR 7 mm 9 mm 10 mm 30 PD = 6.5 mm 5.0 mm 35 PD = 7.0 mm 5.5 mm Right eye: resect MR 6 mm 8 mm 8.5 mm 40 PD = 7.5 mm 6.0 mm Left eye: recess MR 5 mm 6.5 mm 7.0 mm 50 PD = 8.5 mm 6.5 mm Left eye: resect LR 8 mm 10 mm 11 mm

a If in doubt, draw it out (Fig. A9.1 ). Vertical Rectus Muscle Surgery

Tips for Fellow and Resident Preparation Recess up to 1 mm for each 3 PD of desired correction. for Surgery Note: If performing larger recessions of the inferior rectus (>5 mm), surgeon should consider disinsertion To learn the most from each case, review the medical chart of lower eyelid retractors to prevent eyelid ﬁ ssure and prepare a surgical plan. Here is a list of what information should be collected from the medical record prior to the case. changes. 1. Patient age. 2. Prior surgery: If prior surgery, record preoperative and postoperative measurements and the surgical interven- For DVD, please see Chap. 56 on vertical deviations. tion performed. 3. Visual acuity: (Is amblyopia present?) OD: OS: Nystagmus Surgery for Face Turn 4. Cycloplegic refraction OD: Face Turn to the RIGHT (Left Gaze Preference) OS: 5. Versions and ductions: 1. Goal: Move eyes to the RIGHT 6. Gaze measurements at distance and near (review several notes to determine stability of measurements); record Degrees of face turn <20° 30° 45° with and without correction. Left eye: recess LR 7 mm 9 mm 10 mm Left eye: resect MR 6 mm 8 mm 8.5 mm Right eye: recess MR 5 mm 6.5 mm 7.0 mm Right eye: resect LR 8 mm 10 mm 11 mm

Fig. A9.1 (a ) This patient has a a LEFT face turn (right gaze preference). (b ) Draw the present position of the eyes. (c ) Draw the b end position of the eyes (in this case move eyes LEFT) and make RLR RMR LMR LLR sure the surgical plan coincides with this goal. Note: The editor labels the muscles and planned surgical intervention above each muscle of the patient in cases of c nystagmus surgery RLR RMR LMR LLR Recess Resect Recess Resect Appendix 9: Surgical Planning and Numbers 787

RSR LSR RSR LSR Recess Recess 4.5 mm 4.5 mm

RLR RMR LMR LLR RLR RMR LMR LLR

RIR LIR RIR LIR

Fig. A9.2 Trainee can mark the surgical muscles and numbers of recession/resection (a) Example of marking muscles as above

7. Stereopsis: 20 Δ 20 Δ 20 Δ 8. Worth-4-Dot Results 20 Δ 20 Δ 20 Δ 9. Resident/fellow proposed surgical plan (Fig. A9.2 ) 20 Δ 20 Δ 20 Δ 10. Attending surgical plan 11. Intraoperative notes 9/20/2014 (Pre-op visit) ETsc = 50 ETsc′ = 75Δ ETcc = below ET′cc = 30 Δ Example Fellow and Resident Preparation for Surgery 20 Δ 20 Δ 20 Δ 20 Δ 20 Δ 20 Δ 1. Patient age: 3.5-year-old with partially accommodative 20 Δ 20 Δ 20 Δ esotropia 2. Prior surgery: No prior surgery Stereo: none 3. Visual acuity (cc): W4D: Suppression OS OD: 20/30 [CSM] 7. Resident/fellow proposed surgical plan (Fig. A9.3 ): OS: 20/30 [CSuM] (1) Bilateral medial rectus recession for 30 PD, 4.5 mm 4. Cycloplegic refraction (near deviation with correction or distance deviation with OD: +3.00 + 0.50 × 090 correction and add 1 mm to each MR recession) OR left OS: +3.50 + 0.50 × 090 medial rectus recession (4.5 mm) and left lateral rectus 5. Versions and ductions: Full OU resection (5.5 mm) for 30 PD (as left eye is non-dominant, 6. Gaze measurements at distance and near (review several although no amblyopia present) notes to determine stability of measurements); record 8. Attending surgical plan: Bilateral medial rectus recession with and without correction. 30+ 50 8/20/2014 (slightly increased near deviation from visit = = 40 PD (5.5 mm) 7/20) 2 ETsc = 45 ET′sc = 70 Δ 9. Intraoperative notes: Fornix incision, crossing swords ETcc = below ET′cc = 30 Δ technique for muscle reinsertion Appendix 10: ROP Examination and Treatment Pearls

Michael B. Yang

Order of Examination One recommended sequence of that mimics the appearance of stage 1 or 2 ROP or that hides examination outlined below (pupil, optic nerve, then tempo- potential ROP on the downslope of the indented retina away ral, nasal, superior/inferior retina) is based on the likelihood from the examiner’s view. A 28-diopter condensing lens is of detecting examination fi ndings that impact the decision useful for determining the location of disease because if the for treatment or follow-up should an abbreviated examina- nasal border of the optic nerve is placed at one edge of the tion become necessary due to physiologic instability in the afforded view during binocular indirect ophthalmoscopy, the infant [1 ]. (1) Check the pupil for iris neovascularization. (2) other edge of the view marks the temporal boundary of zone Check the optic nerve and posterior pole vessels to evaluate I [ 2 ]. A 20-diopter lens allows the visualization of the details for the presence of plus disease. The diagnosis of plus dis- of plus disease and stage 3 ROP. ease may be subjective. Thus, recalibration of one’s mental image of plus disease periodically by comparison with stan- Laser Photocoagulation Surgery may be performed under dard photographs from ICROP is recommended [2 ]. (3) general anesthesia in the operating room or sedation in the Check the temporal 4 clock hours of retina to determine if nursery. Typical initial settings for a portable diode laser the ROP is in zone I or close to the macula, as disease sever- used in ROP treatment (Oculight XLS, Iridex, Mountain ity is usually greatest in the temporal retina followed by the View, CA) are 100 mW power, 300 ms duration, and 300 ms nasal retina and then the superior/inferior retina. (4) Check repeat interval. The power is gradually increased until a the nasal 4 clock hours of retina to determine whether the gray-white burn is achieved with the spots set about one-half nasal retina is vascularized to the ora serrata for 2 clock burn width apart. Applying a row of laser spots to the avas- hours. If so, then by defi nition retinal vascularization has cular retina just peripheral to the vascular-avascular junction proceeded into zone III temporally. (5) Check the superior 360° serves to mark off the posterior extent of the planned and inferior retina last as these areas are unlikely to have a treatment. If the view becomes blurry during treatment, one higher stage of ROP than the temporal or nasal retina. can more safely complete the laser procedure by ablating the avascular retina peripheral to the fi rst row of laser. Examination Equipment An Alfonso lid speculum (Storz E4112) effectively retracts the eyelids. The sclera can be Bevacizumab Injection A different drug lot can be used indented by using a calcium alginate swab with a thin alumi- for each eye if bilateral therapy is planned. Slightly more num shaft or by using a Flynn scleral depressor (Storz than the standard dose of 0.625 mg of bevacizumab in E5107). The latter can create a line of white with pressure 0.025 ml should be drawn by the pharmacist directly from the manufacturer supplied vial in a 1-ml tuberculin syringe which is then fi tted with a 30-gauge needle without a safety M. B. Yang, M.D. guard that can impede injection. The treating physician can Abrahamson Pediatric Eye Institute, Cincinnati Children’s waste the excess just before injection. Povidone-iodine 5 % Hospital Medical Center, 3333 Burnet Ave, MLC 4008 , Cincinnati , OH 45229- 3039 , USA solution for endophthalmitis prophylaxis is instilled in the eye for a few minutes before injection. Then cotton applica- Department of Ophthalmology , University of Cincinnati College of Medicine, 3333 Burnet Ave, MLC 4008 , Cincinnati , tors soaked with topical anesthetic are applied to the injec- OH 45229-3039 , USA tion site. Pretreatment with systemic pain medication

© Springer Science+Business Media, LLC 2016 789 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 790 Appendix 10: ROP Examination and Treatment Pearls should be considered. The treating physician’s fi nger should References not touch the plunger until the needle has been inserted through the sclera as the minutest pressure will cause a 1. Chiang MF, Melia M. Buffenn AN, et al. Detection of clinically small amount of drug to escape at the needle tip. The injec- signifi cant retinopathy of prematurity using wide-angle digital photography: a report by the American Academy of Ophthalmology. tion site should be measured at 0.5–1.0 mm from the cor- Ophthalmology 2012; 119: 1272–80. neal limbus since the pars plana is narrow in the premature 2. Cryotherapy for Retinopathy of Prematurity Cooperative Group. infant [3 ]. The eye should be immobilized with forceps or a 15-year outcomes following threshold retinopathy of prematurity : cotton tip applicator, while the sclera is penetrated with the fi nal results from the multicenter trial of cryotherapy of retinopathy of prematurity. Arch Ophthalmol. 2005; 123: 311–8. needle aimed toward the optic nerve to avoid injuring the 3. Simpson JL, Melia M, Yang MB, et al. Current role of cryotherapy lens. As the needle is withdrawn, the injection site is blotted in retinopathy of prematurity: a report by the American Academy of with a cotton tip applicator. Ophthalmology. Ophthalmology. 2012; 119:873–7. Appendix 11: ROP Follow-Up Schedule

Michael B. Yang

The policy statement of the pediatric and ophthalmology previous ROP in zone I or II and in an infant ≥35 weeks specialty organizations in the United States recommends an PMA, (3) the attainment of 50-week PMA in an infant with- initial ROP examination at 31 weeks postmenstrual age out the presence of prethreshold ROP or worse disease, or (PMA) or 4 weeks chronological age, whichever is later, for (4) absence of vascular tissue that can reactivate after previ- premature infants ≤1500 g birth weight or ≤30 weeks esti- ous regression of ROP in zone II or III. mated gestational age at birth. The responsibilities for educating the family of premature The recommended intervals for follow-up examinations infants at risk for ROP and ensuring timely follow-up exami- based on retinal ﬁ ndings using the revised International nations (whether inpatient or after hospital discharge) should Classiﬁ cation of ROP [14 ] (Table 29.2) are as follows: 1 be carefully delineated between the neonatal intensive care week or less for immature vascularization in zone I or in the unit (NICU) staff and the examining ophthalmologist [16 ]. It posterior aspect of zone II near the zone I border, stage 1 or may be prudent for the ophthalmologist to also indepen- 2 ROP in zone I, stage 3 ROP in zone II, or the presence or dently keep track of the infants who warrant follow-up suspected presence of aggressive posterior ROP; 1 to 2 examinations rather than rely solely upon the NICU to week(s) for immature vascularization in posterior zone II, schedule them correctly.1 stage 2 ROP in zone II, or unequivocally regressing ROP in zone I; 2 weeks for stage 1 ROP in zone II, immature vascularization in zone II, or unequivocally regressing ROP in zone II; and 2 to 3 weeks for stage 1 or 2 ROP in zone III or regressing ROP in zone III. The suggested criteria for termination of screening examinations include (1) full retinal vascularization (mature), (2) retinal vascularization into zone III without

1 Many of these recommendations are based on evidence from multi- M. B. Yang, M.D. center studies, but they do not account for center-specifi c differences or Abrahamson Pediatric Eye Institute, Cincinnati Children’s Hospital infant characteristics that may modify the risk of individual infants. Medical Center , 3333 Burnet Ave, MLC 4008 , Cincinnati , Ophthalmologists who wish to deviate from the recommended ROP OH 45229-3039 , USA screening guidelines may benefi t from developing institutional consen- Department of Ophthalmology , University of Cincinnati College of sus after a careful review of center-specifi c evidence. However, some Medicine, 3333 Burnet Ave, MLC 4008 , Cincinnati , insurance companies may not provide liability coverage, if examiners OH 45229-3039 , USA deviate from the guidelines.

© Springer Science+Business Media, LLC 2016 791 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 Appendix 12: Pseudotumor Cerebri Diagnostic Criteria

Grant T. Liu

G. T. Liu, M.D. Department of Ophthalmology , Children’s Hospital of Philadelphia, 34th and Civic Center Blvd. , Philadelphia , PA 19104 , USA

© Springer Science+Business Media, LLC 2016 793 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 794 Appendix 12: Pseudotumor Cerebri Diagnostic Criteria

PTCS diagnostic criteria PTCS suspect?

Normal neurologic examination (except cranial nerve palsies) Normal brain parenchyma* Normal CSF composition

Papilledema present No papilledema LP opening pressure > 280 mm CSF (or 250 mm CSF if not sedated or obese)

LP opening pressure > 280 mm CSF LP opening pressure < 280 mm CSF (or 250 mm CSF if not sedated or obese) (or 250 mm CSF if not sedated or obese) Definite PTCS Probable PTCS

Sixth nerve palsy No sixth nerve palsy PTCS without papilledema

At least 3 of the following MRI criteria: Fewer than 3 of the MRI criteria • Empty sella • Flattening of the posterior aspect of the globe Not PTCS • Distended periopticsubarachnoid space +/-optic nerve tortuosity • Transverse venous sinus stenosis Suggested PTCS

*As seen on contrast-enhanced MRI neuro-imaging for typical patients (female and obese), plus MR-venography for atypical patients (male or non- obese female);or contrast-enhanced CT if MRI is not obtainable.

Fig. A12.1 PTCS diagnostic criteria ﬂ ow chart Appendix 13: Anisocoria

Greg Kosmorsky

Figure A13.1 • Hydroxyamphetamine (instill 24 h after cocaine): – Mechanism: Releases NE from presynaptic nerve 1. The diagnosis of physiologic anisocoria is based on a terminal brisk reaction with no dilation lag (e.g., the anisocoria is – Testing: equal in both dim and light conditions). Physiologic Postganglionic : Abnormal (smaller) pupil does anisocoria is usually ≤1 mm. not respond and remains miotic with testing 2. If there is brisk reaction to light , but dilation lag (e.g., (nerve terminal has degenerated). anisocoria is greater under dim conditions), the differential Preganglionic: Abnormal (smaller) pupil dilates diagnosis includes Horner syndrome as well as mechani- as much (if not more) than the normal pupil cal or pharmacologic miosis. Both apraclonidine and (postganglionic neuron is intact). cocaine testing can be used to determine if a Horner syn- – Acquired Horner syndrome requires further drome is present, but do not distinguish between pregangli- diagnostic workup in the pediatric population as onic and postganglionic lesions. Hydroxyamphetamine is the differential includes trauma, malignancy, used to distinguish between preganglionic and postgangli- and neuroblastoma of the sympathetic chain. onic involvement. Diagnostic workup should include imaging of • Apraclonidine 1 % testing: the brain, neck, and chest. Urine catecholamines – Mechanism: Apraclonidine inhibits the alpha-2 could also be considered. receptor on the presynaptic nerve terminal inhibit- 3. If there is a poor reaction to light (anisocoria greater in ing norepinephrine release. dim illumination), the following etiologies must be care- – Testing: Normal eye constricts. Abnormal fully distinguished: (smaller) pupil dilates because there is adrenergic • Mechanical etiology: Evaluate at slit lamp for transil- supersensitivity (increased alpha-1 receptors) on lumination defects, sphincter tears, synechiae, or post- the iris dilator muscle. Apraclonidine has weak surgical abnormalities of the pupil alpha-1 activity leading to the dilation observed. • Adie’s tonic pupil: An Adie’s pupil is caused by post- **Use caution in young children as it may cause seda- ganglionic parasympathetic denervation and is usually tion because of CNS affects** unilateral. A tonic pupil is usually poorly reactive, and • Cocaine: Blocks reuptake of norepinephrine (NE) at occasionally sectoral segments of sphincter paralysis presynaptic nerve terminal can be observed at the slit lamp. Diagnostic testing can – Testing: Normal pupil will dilate. Abnormal be performed with dilute 0.1 % pilocarpine: (smaller) pupil will not dilate because little or no – Mechanism: Pilocarpine is a direct-acting choliner- NE is released into the synapse. gic agonist. – Testing: 0.1 % Pilocarpine: The denervated iris sphincter is supersensitive to dilute 0.1 % pilocarpine and will constrict. The normal pupil will have minimal reaction at this dilute concentration. G. Kosmorsky, D.O. Department of Ophthalmology, Cleveland Clinic, Cole Eye *** Note: An early Adie’s pupil may not be supra- Institute I-30, 9500 Euclid Ave , Cleveland , OH 44195 , USA sensitized and yield a false-negative test. It is prob-

© Springer Science+Business Media, LLC 2016 795 E.I. Traboulsi, V. Miraldi Utz (eds.), Practical Management of Pediatric Ocular Disorders and Strabismus, DOI 10.1007/978-1-4939-2745-6 796 Appendix 13: Anisocoria

No dilation lag Simple or physiologic (Equal pupil size in anisocoria dim & light)

Brisk reaction 1% Apraclonidine dilates smaller pupil & Horner syndrome elevates eyelid Dilation lag (Anisocoria greater in dim light) Physiologic anisocoria No dilation with or mechanical/ Apraclonidine 1% pharmacological miosis

TIDs, sphincter tears, Iris damage post-surgery damage Light reflex

Cholinergic sensitivity to Adie’s pupil dilute 0.1% pilocarpine

Sectoral palsy on SLE Adie’s pupil

Poor reaction in one or both eyes Anisocoria No constrictition with Pharmacologic blockade (greater in dim light) 1% Pilocarpine or early Adie’s pupil Normal iris with complete paralysis Constricts with 1% 3rd Nerve Palsy Pilocarpine

No constrictition with Pharmacologic blockade 1% Pilocarpine or early Adie’s pupil

No sectoral palsy on SLE

Constricts with 1% 3rd Nerve Palsy Pilocarpine

Fig. A13.1 Diagnostic algorithm for the patient with anisocoria. The light reﬂ ex is a test of the efferent system beginning at the Edinger-Westphal nucleus. Key: TIDs = transillumination defects

ably better to assume a possible pupil-involving References third nerve palsy and image accordingly for aneurysm. *** 1. Miller JM, Harvey EM. Spectacle prescribing recommendations of 1 % Pilocarpine: Both normal and abnormal pupils should AAPOS members. J Pediatr Ophthalmol Strabismus. 1998;35(1):51–2. constrict. If the abnormal (dilated) pupil fails to con- 2. American Academy of Ophthalmology. Pediatric eye evaluations, strict to 1 % pilocarpine, then it is likely pharmaco- preferred practice pattern. San Francisco, CA: American Academy logically dilated. If the abnormal pupil (dilated) of Ophthalmology; 2012. pupil constricts appropriately, a third nerve palsy 3. Donahue SP, Arthur B, Neely DE, Arnold RW, Silbert D, Ruben JB, Committee POSVS. Guidelines for automated preschool vision must be evaluated by neuroimaging for vascular mal- screening: a 10-year, evidence-based update. J AAPOS. formation, aneurysm, and malignancy compressing 2013;17(1):4–8. the pupillary ﬁ bers. Other clinical signs of a partial or 4. Donahue SP, Arnold RW, Ruben JB, Committee AVS. Preschool full third nerve palsy may be present (ptosis, adduc- vision screening: what should we be detecting and how should we report it? Uniform guidelines for reporting results of preschool tion, supraduction, or infraduction deﬁ cit). vision screening studies. J AAPOS. 2003;7(5):314–6. Appendix 13: Anisocoria 797

5. Schramm KD. Dispensing pediatric eyewear. Oxford: Butterworth- 12. Parks MM. Ocular motility and strabismus. New York, NY: Harper Heinemann; 2000. and Row; 1975. pp. 108, 120, 121. 6. Meister D, Sheedy JE. Introduction to ophthalmic optics. San 13. Paysee EA, Coats DK, Sprunger DT. Predictive value of temporal Diego, CA: Carl Zeiss Vision; 1999–2000. p. 69. retinal disease in retinopathy of prematurity. J Pediatr Ophthalmol 7. Cotter SA. Clinical uses of prism. A spectrum of applications. St. Strabismus. 1997;34:177–81. Louis, MO: Mosby; 1995. 14. International Committee for the Classifi cation of Retinopathy of 8. Meister D, Sheedy JE. Introduction to ophthalmic optics. San Prematurity. The international classifi cation of retinopathy of pre- Diego, CA: Carl Zeiss Vision; 1999–2000. p. 57. maturity revisited. Arch Ophthalmol. 2005;123:991–9. 9. Jabs DA, Nussenblatt RB, Rosenbaum JT. Standardization of 15. Hairston RJ, Maquire AM, Vitale S, Green WR. Morphometric analy- Uveitis Nomenclature Working G. Standardization of uveitis sis of pars plana development in humans. Retina. 1997;17:135–8. nomenclature for reporting clinical data. Results of the First 16. Section on Ophthalmology, American Academy of Pediatrics, International Workshop. Am J Ophthalmol. 2005;140(3):509–16. American Academy of Ophthalmology, and American Association 10. Good WV, Hoyt CS. Strabismus management. Boston, MA: for Pediatric Ophthalmology and Strabismus, and American Butterworth-Heinemann; 1996. pp. 217, 234, 362, 280, 323. Association of Certifi ed Orthoptists. Screening examinations of 11. Mitchell PR, Wheeler MB, Parks MM. Kestenbaum surgical proce- premature infants for retinopathy of prematurity. Pediatrics. dure for torticollis secondary to congenital nystagmus. J Pediatr 2013;131:189–95. Ophthalmol Strabismus. 1987;24:87–93. Index

A Shaken baby syndrome , 313 A- and V-pattern strabismus , 586–589 skeletal survey , 317 bilateral superior oblique overaction , 591 Accommodative convergence to accommodation (AC/A) ratio , 496 craniosynostosis syndromes , 584 Accommodative esotropia , 37 , 39 , 41 horizontal rectus muscle dysfunction , 584 AC/A ratio , 496 , 499 , 500 oblique muscle overaction , 584 atropine relaxation , 496 ocular misalignment , 590 augmentation , 497 treatment augmented and slanted recessions , 500 oblique muscle surgery , 589 binocular development , 500 rectus muscle surgery , 586–589 binocular function , 496 upgaze and downgaze , 583 binocular vision and stereopsis , 496 vertical rectus muscle dysfunction , 584 characteristics vs . results , 500 , 501 AAO . See American Academy of Ophthalmology (AAO) diagnosis and treatment , 496 A A P . See American Academy of Pediatrics (AAP) dosage calculation , 497 , 498 , 500 Abraham, A. , 547 , 548 , 550–554 ET and hyperopia , 498 Abusive head trauma , 314–318 glasses/contact lenses , 497 bilateral thin-fi lm subdural hemorrhages , 317 hyperopia , 495–497 , 502 brain injury , 317 infantile esotropia syndrome , 496 child abuse , 313 medial rectus recessions , 500 , 501 Child Abuse Pediatrics Team , 317 refractive correction , 500 child maltreatment , 313 single and double vision , 496 CPS , 313 spectacle bifocal and hyperopic correction , 502 diagnosis spectacle correction , 497 abusive injuries , 314 spectacle weaning technique , 502 acceleration-deceleration injuries , 314 strabismus surgery , 497 cataracts and lens subluxation , 315 surgical treatment , 501–502 child’s developmental abilities , 314 visual system , 497 color fundus photograph , 314 , 315 weaning , 502 deprivation amblyopia , 318 Accommodative non-refractive esotropia , 496 endocarditis , 314 ACE . See Angiotensin-converting enzyme (ACE) fundus photography , 316 Achromatopsia , 295 , 339–341 hemorrhages , 316 Acids , 159 hemorrhagic macular schisis cavities , 314 ACMG . See American College of Medical Genetics (ACMG) hemosiderin , 314 Acquired immunodefi ciency syndrome (AIDS) , 244 international classifi cation system , 316 Acquired sixth nerve palsy , 507–508 interobserver differences , 316 Acquired traumatic cataract macular schisis cavity , 318 CPC , 465 non-accidental trauma , 314 GDD , 465 ophthalmology consultation , 314 glaucoma , 465 retinal hemorrhages , 314–316 history , 464 , 465 retinal photography , 314 interval history (6 months) , 465 retinal/visual sequelae , 317 management , 465 retinopathy , 316 Acute acquired comitant esotropia , 489 subconjunctival hemorrhage , 314 Acute demyelinating encephalomyelitis (ADEM) subdural hemorrhage , 314 description , 430 subhyaloid hemorrhage , 314 infl ammatory demyelinating disease , 431 traumatic retinoschisis , 314 lumbar puncture , 431 vitreous hemorrhage , 314 monophasic illness , 433 dilated indirect ophthalmoscopy , 317 Acute infl ammatory DON . See Demyelinating optic neuritis (DON) hemorrhagic macular schisis cavities , 317 Acute posterior multifocal placoid pigment epitheliopathy optimal visual function , 317 (APMPPE) , 230

Acute retinal necrosis (ARN) , 242 , 243 macular edema and submacular fl uid OCT , 431 , 433 Acute strabismus MRI , 431 , 435 , 436 adult patients , 635 NMO and MOG antibodies , 431 clinical evaluation , 636–637 OCT , 430 clinical features , 635–636 spectral domain OCT with acute DON , 431 , 434 etiology , 636 VEP signal , 431 management , 637 Angiotensin-converting enzyme (ACE) , 431 Adamantiades–Behcet’s disease (ABD) , 230 Angle kappa Adamopoulou, C. , 81–97 esotropia , 14 ADEM . See Acute demyelinating encephalomyelitis (ADEM) strabismus assessment , 13 Adjustable suture technique , 569 Anisometropia , 75 , 77 Afferent pupillary defect (APD) , 83 Anisometropic amblyopia , 88 , 92 , 93 Aggressive posterior ROP (AP-ROP) , 301 bangerter fi lter , 93 Akar, S. , 500 , 509 BCVA Alkali injury , 159 atropine , 88 , 92 , 93 Allergic conjunctivitis patching , 88 AKC , 106 contact lens , 93 chronic red eyes , 105 prescribed glasses , 87 eczema and allergies , 105 refractive correction , 88 itching and eye rubbing , 105 Anisometropic or strabismic or combined mechanism , 89 , 91 VKC , 106 Anomalous retinal correspondence (ARC) Al-Nammari, S. , 669 binocular conditions , 30 Amaro-Quireza, L. , 291 , 293 , 295 eye misalignment , 29 Amblyopia , 48 , 137 , 138 , 175 , 177 , 181 , 660 , 662 , 719 harmonious/nonharmonious , 29 Amblyopia management , 83–85 , 94 , 95 NRC , 30 BCVA , 81 paradoxical diplopia , 2 9 binocular treatments , 96 Anterior segment dysgenesis syndromes children >7 years of age , 94 Axenfeld–Rieger syndrome , 141 clinical examination , 83 clinical fi ndings , 142 defi nition, amblyopia , 82 diagnosis , 144–145 deprivation amblyopia , 82 , 83 genetics , 144 diagnostic and therapeutic algorithm , 97 glaucoma , 143–144 moderate amblyopia , 89 management and Prognosis , 145–146 moderate to severe amblyopia , 85 , 93 , 94 posterior embryotoxon , 142 occlusion therapy , 85 , 86 spectrum , 143 ocular dominance columns , 82 Anterior segment herpetic disease PEDIG trials , 89–92 amblyopia , 126 refractive amblyopia , 82 anterior segment , 120 residual amblyopia anterior segment herpetic eye disease , 127 levodopa , 94 drug management , 127 occlusive and pharmacologic , 94 epithelial keratitis , 120 refractive surgery , 95 evidence-based oral antiviral treatment protocols , 120 risk factors , 81 herpes virus infections , 119 deprivation amblyopia , 83 herpetic keratitis , 126 refractive amblyopia , 83 HSV-1 and HSV-2 , 120 refractive and deprivation amblyopia , 83 mobility and photophobia , 127 screening guidelines , 83 ocular herpes , 120 strabismic amblyopia , 82 oral acyclovir , 127 from strabismus pediatric herpes infection , 126 occlusive penalization , 84 polymerase chain reaction (PCR) , 120 patching , 85 trigeminal nerve (CN V) , 120 Surgical correction , 84 VZV , 125–126 treatment strategies , 82 VZV and CMV , 119 visual acuity , 86 , 87 Anterior segment ischemia , 645–646 Amblyopia Treatment Study 2C (ATS2C) , 85 Anterior segment OCT (AS-OCT) , 285 American Academy of Ophthalmology (AAO) , 331 , 560 Apert syndrome , 130 , 710 , 721 American Academy of Pediatrics (AAP) , 214 , 215 , 331 Aphakic infant fi t with GP lens , 69 , 70 American Association for Pediatric Ophthalmology and Strabismus Aphakic infant fi t with Silsoft lens , 69 (AAPOS) , 3 9 , 8 4 Aphakic/pseudophakic glaucoma American College of Medical Genetics (ACMG) , 331 cataract , 457 Amyloid precursor protein (APP) , 737 childhood cataract surgery , 458 Amyloid-β peptide (Aβ) , 737 CPC , 458 Ancillary ophthalmic testing cyclodestructive procedures , 459 automated visual fi elds , 430 diagnosis , 457 HVF 24-2 SITA fast visual fi elds , 431 , 432 EUAs , 458 lumbar puncture , 431 GDD , 458 Index 801

Goldmann applanation tonometry , 458 Beck, A.D. , 442 IATS , 458 Best-corrected visual acuity (BCVA), 81 , 88 , 90 , 92 , 93 IOP and glaucoma , 457 Bevacizumab Eliminates the Angiogenic Threat of ROP (BEAT-ROP) , medical therapy , 458 302–303 micro-catheter , 458 Bhandari, R. , 138 risk factors , 458 Bhardwaj, G. , 316 trabeculectomy, mitomycin C , 459 Bhatti, M.T. , 427–431 , 433 , 435–437 WGA Consensus , 457 Bielschowsky Head Tilt test , 627 Apputukan , 550 Bilateral congenital cataracts ARC . See Anomalous retinal correspondence (ARC) aphakic glaucoma , 460 , 462 Archer, S.M. , 552 history , 459 , 461 , 462 Ariss, M.M. , 103–107 , 150–152 , 313–318 , 547 , 548 , 550–554 , 635 , interval history (1 year) , 460 637–639 interval history (2 months) , 462 Arnold–Chiari malformation , 751 interval history (4 months) , 463 Aronow, M.E. , 370 interval history (5 months) , 462 Astigmatism , 51 interval history (6 weeks) , 460 amblyopia , 52 IOP , 460 correction , 52 management , 459 , 462 correction, refractive errors , 52 pseudophakic glaucoma , 463 cycloplegic retinoscopy , 52 Bilateral Group E retinoblastoma , 389 guidelines , 52 Bilateral isoametropic amblyopia , 91 irregular (see Irregular astigmatism ) Bilateral keratitis , 239 preferred practice pattern , 52 Bilateral sixth nerve palsy , 508 preferred practice patterns , 52 Binocular vision regular (see Regular astigmatism ) diplopia , 27 survey , 52 fusion , 26–27 Atopic keratoconjunctivitis (AKC) , 106 fusional vergence amplitudes , 27 Atrophic nerves , 274–275 horror fusionis , 28 Atropine , 92 , 93 monoﬁ xation syndrome , 26 , 27 Avery, R.A. , 411 sensory and motor fusion , 27 Axenfeld–Rieger syndrome , 141–145 , 332 stereopsis , 27 visual confusion , 27 Blau syndrome , 226 B Blepharophimosis, ptosis, and epicanthus inversus syndrome Babiuch, A.E. , 25–34 , 469–472 , 474 (BPES) , 660 Bacterial conjunctivitis Blepharoptosis aminoglycoside , 104 blepharophimosis syndrome , 663 antibiotics , 104 BPES , 660 azithromycin , 104 and chronic progressive external ophthalmoplegia , 661 contact lens , 104 complications , 664 discharge , 104 congenital ptosis , 664 Neisseria and chlamydia , 104 cranial nerve III paresis , 660 pathogens , 104 craniofacial and genetic syndromes , 660 placebo vs . antibiotics , 104 diagnostic evaluation , 661–662 polymyxin and bacitracin ointment , 104 double elevator palsy , 660–661 polymyxin B-trimethoprim , 104 Fasanella–Servat procedures , 664 Bacterial keratitis , 112 , 113 frontalis suspension procedure , 664 corneal ulcers , 113 Horner syndrome , 661 , 663 diagnosis , 112 Kearns–Sayre syndrome , 661 pathogenesis , 112 levator muscle , 659 risk factors , 112 Müller’s Muscle resection , 664 treatment myasthenia gravis , 660 antimicrobials , 112 myotonic dystrophy , 661 corticosteroids , 113 ptosis , 660–662 drop vs . ointment formulations , 112 superior tarsal muscle , 659 monotherapy , 113 surgical management , 662 Bagolini striated lenses , 32 Synkinetic syndromes , 661 Bahl, R.S. , 513 , 514 , 516 , 517 , 521 , 525–527 , 531 , 583 , 584 , 586 , 588 , Boente, C.S. , 135–138 , 141–145 589 , 591 Bosch, M.M. , 366 Bain, K.E. , 759 Boston Children’s Hospital (BCH) , 410 , 411 Balloon catheter dilation , 655–657 Bourneville disease , 370–372 Bangerter Filter Treatment Study , 93 Bowsher, J.D. , 605 , 606 , 608 , 610 Bardet-Biedl syndrome (BBS) , 342–344 BPES . See Blepharophimosis, ptosis, and epicanthus inversus Barry, J. , 625 syndrome (BPES) Batten disease (Jansky-Bielschowsky disease) , 283 Brachytherapy , 390 , 391 Baumal, C.R. , 244 Bradﬁ eld, Y.S. , 469–472 , 474 BCVA . See Best-corrected visual acuity (BCVA) Brodie, S.E. , 321–324 802 Index

Brodsky, M.C. , 606 glaucoma-fi ltering surgery , 450 Brown syndrome , 628 , 630 , 631 gonioscopy , 450 alternate cover test , 627 management , 450 anomalous head posture , 630 optic nerves , 450 diagnosis , 624 prominent posterior embryotoxon , 450 E.O.M. , 624 cycloablation , 455 left brown syndrome esotropia F.D.T. , 627 , 629 , 630 anterior segment examination , 453 head turn status , 630 , 631 B-scan ultrasound , 453 management , 624 dome-shaped hyperechoic mass , 453 oblique surgery , 630 enucleation vs . intra-arterial chemotherapy , 454 right eye , 624 , 625 Icare® , 453 alternate cover test , 628 posterior segment examination , 453 ocular motility profi le , 628 retinoblastomas , 454 silicone expander , 630 vitreous cavity , 453 Y-pattern exotropia , 626 , 627 eye pain Brown, H.W. , 623 acetazolamide , 452 Broxterman, E. , 635 , 637–639 anterior chamber , 451 , 452 Brugha, R.E. , 669 anterior segment examination , 450–452 B-scan ultrasonography , 400 , 402 , 563 apraclonidine , 452 B-scan ultrasound , 402 B-scan , 451 Buck, D. , 538 fi brinous membrane , 451 fl at retina and choroid , 451 goniotomy , 452 C juvenile idiopathic arthritis (JIA) , 451 CAIs . See Carbonic anhydrase inhibitors (CAIs) keratic precipitates (KP) , 451 Calhoun, J.H. , 750 medical and surgical therapies , 452 Campagna, M. , 412 palpation , 450 Capillary hemangioma , 689 posterior segment examination , 451 Carbonic anhydrase inhibitors (CAIs) , 442 scleral depression , 451 Carrai, P. , 213–217 , 219 , 220 , 251 , 253–256 Tonopen® , 451 , 452 Cataracts , 366 , 737 ultrasound biomicroscopy , 451 Cat-scratch disease (CSD) uveitis , 451 , 452 antibiotic therapy , 239 fi ltering surgery , 454 diagnosis , 239 glaucoma drainage devices , 455 immunocompetent patients , 239 juvenile open-angle glaucoma , 448 neuroretinitis , 239 pediatric glaucoma , 439 ocular complication , 239 pediatric glaucoma surgery , 454 transmission , 239 right eye pain Cavernous hemangioma , 691 anterior segment examination , 452 , 453 Cavuoto, K.M. , 641–646 B-scan , 452 CBC . See Complete blood count (CBC) C/D ratio measure , 453 CCDD . See Congenital cranial dysinnervation disorders (CCDD) carbonic anhydrase inhibitors (CAIs) , 453 Centers for Medicare and Medicaid Services (CMS) , 329 ciliary body band , 453 Central corneal thickness (CCT) , 203 gonioscopy , 453 Central, steady, and maintained (CSM) , 445 hand motion (HM) , 452 Central, steady, and unmaintained (CSuM) , 445 hyphema , 453 CGRN . See Childhood Glaucoma Research Network (CGRN) Icare® , 452 Chandler, J.R. , 668 intact posterior segment , 452 Chemotherapy , 388–390 management , 453 retinoblastoma Tonopen® , 452 , 453 intra-arterial , 388–390 Schlemm canal , 454 intravenous , 388 , 389 scleral fl ap , 454 intravitreal , 390 secondary amblyopia and strabismus , 439 periocular , 390 strabismus , 455 Child physical abuse , 317 Sturge–Weber Syndrome Child Protective Services (CPS) , 313 anterior segment examination , 448 Childhood glaucoma , 448–454 antiepileptics and stroke , 448 acetylcholine , 454 bimodal distribution , 449 Ahmed valve chamber , 455 C/D ratio , 449 angle surgery , 454 choroidal hemangioma , 449 anterior chamber , 454 glaucoma drainage device (GDD) , 449 classifi cation , 439–440 glaucoma drainage valve , 449 corneal abrasion gonioscopy , 449 anterior segment examination , 450 medical and surgical management , 449 Axenfeld-Rieger (AR) spectrum disorder , 450 posterior segment examination , 449 genetics evaluation , 450 Prominent superior and inferior arcuate defects , 449 Index 803

trabeculotomy , 454 Congenital glaucoma , 144 , 145 viscoelastic device , 454 Congenital orbital cystic lesions Childhood Glaucoma Research Network (CGRN) , 439 dermoid cysts , 684 Children’s Hospital of Philadelphia (CHOP) ROP algorithm , 301 microphthalmia with cyst , 682–683 Chorioretinitis , 238 teratoma , 684–685 Choroidal neovascularization (CNV) , 402 Congenital sixth nerve palsy , 506–507 Choroideremia , 283 Congenital stationary night blindness (CSNB) , 293 Choudhary, M. , 593–596 , 598–602 Conjunctivitis , 103 Chromosomal microarray (CMA) , 331 characteristics , 103 Clefting syndromes , 712–713 childhood , 103 CLIA . See Clinical Laboratory Improvement Amendments (CLIA) infectious viral and bacterial , 103 Clinical activity score (CAS) system , 562 noninfectious , 103 Clinical assessment score (CAS) system , 562 serotypes , 103 Clinical Laboratory Improvement Amendments (CLIA) , 329 Copy number variation (CNV) , 335 Cloquet canal , 193 Corneal anesthesia CMA . See Chromosomal microarray (CMA) amniotic membranes act , 133 CMS . See Centers for Medicare and Medicaid Services (CMS) anesthetic corneas , 133 C M V . See Cytomegalovirus (CMV) anti-infl ammatory agents , 133 C N V . See Copy number variation (CNV) antimicrobial therapy , 132 Coats’ disease , 194 , 354 Apert syndrome , 130 Cohen syndrome , 205–206 autologous serum , 133 Colobomatous microphthalmia categories , 129 classifi cation , 398 , 400 classifi cation, congenital corneal anesthesia , 130 Combined hamartomas of the retina and RPE (CHRRPE) , 366 craniosynostoses , 130 Comparative genomic hybridization (CGH) , 335 , 336 cyanoacrylate , 132 Complete blood count (CBC) , 451 epithelial keratopathy , 129 Compound heterozygous , 335 eyelid-altering diseases , 130 Computed tomographic (CT) , 564 familial congenital corneal anesthesia and familial trigeminal Cone dysfunction , 295 anesthesia , 131 Cone rod dystrophy , 278–281 fungal cultures , 132 Confocal scanning laser ophthalmoscope (cSLO , 263 history and exam elements , 132 Congenital cataract, right eye interpalpebral distance , 131 history , 463 lagophthalmos , 129–132 interval history (1 year) , 463 nerve growth factors and neurotransmitters , 129 management , 463 orbicularis oculi muscle dysfunction , 130 pseudophakic glaucoma , 463 palpebral insuffi ciency , 130 Congenital cranial dysinnervation disorders (CCDD) , 526 pediatric corneal anesthesia and exposure keratopathy , 133 follow-up examination , 602 punctal occlusion , 133 impression , 601 treatment , 132 management , 601 Corneal leukoma , 135 ocular motility , 593 Corticosteroids , 560 rationale , 601–602 Costenbader, F.D. , 480 Congenital esotropia . See Infantile esotropia Costin, B.R. , 675–679 Congenital Esotropia Observational Study (CEOS) , 484 Cotter, S.A. , 83 , 88 Congenital fi brosis of the extraocular muscles (CFEOM) Cover testing amblyopia , 598 cycle mode and distance fi xation , 9 A-pattern strabismus , 599 occluder , 9 exotropic fi brosis cases , 599 strabismus and motor fusion state , 9 extraocular muscles , 600 Cover-uncover test , 9 head posture and ocular deviation , 600 CPS . See Child Protective Services (CPS) horizontal rectus transposition , 600 Cranial nerve III palsy hypertropia , 599 amblyopia , 528 hypotropia , 599 aneurysms , 526 inferior rectus , 600 bilateral congenital , 526 inferior rectus recession , 599 , 600 cranial surgery/neurosurgery , 526 Möbius syndrome , 600 diagnosis , 526–527 nasal transposition, inferior rectus , 600 infectious and infl ammatory etiologies , 526 paralytic and fi brotic muscle , 600 levator palpebrae muscles , 525 planning surgery , 600 management , 527 plication , 600 medical records , 526 ptosis , 598 muscles , 525 stay sutures , 599 neoplastic causes , 526 strabismus and abnormal head posture , 598–600 oculomotor palsy , 525 strabismus surgery , 599 orthotropia , 528 superior rectus resection , 599 population-based study , 526 synergistic horizontal divergence , 600 spontaneous resolution , 531 vertical and horizontal overcorrections , 600 vascular abnormalities , 526 804 Index

Cranial nerve palsies , 240 , 635 , 637 , 639 diseases with Cranial Nerve VI (CN VI) , 506 ADEM , 431–433 Craniofacial disorders MS , 433–436 amblyopia , 719 NMO , 433 craniosynostosis , 719 , 720 idiopathic monophasic/chronic/recurrent demyelinating cycloplegic refraction , 719 condition , 430 diplopia , 719 long-term management , 436 horizontal rectus muscle surgery , 720 with normal brain MRI , 436 ocular torticollis , 720 with suspected NMO , 437 strabismus , 719 treatment , 436 Craniosynostosis , 719 unilateral/bilateral asymmetric cases , 430 Apert syndrome , 710 Deprivation amblyopia , 82 , 83 , 95 bone growth , 707 Dermoid cysts , 684 brain and cerebral spinal fl uid (CSF) , 707 Descemet stripping automated endothelial keratoplasty branchial arches , 706 (DSAEK) , 137 calvarium , 707 Devic disease . See Neuromyelitis optica (NMO) clefting anomalies , 706 DHD . See Dissociated horizontal deviation (DHD) clefting syndromes , 712–713 Dhoot, S.B. , 313–318 craniofacial deformities , 705 Diamond, G.R. , 720 Crouzon syndrome , 709–710 , 716 Diffuse unilateral subacute neuroretinitis (DUSN) fetal development, facial prominences , 706 electroretinographic changes , 237 hemifacial microsomia , 715 unilateral vision loss , 238 hypertelorism , 707 Diode cyclophotocoagulation (CPC) , 458 maxillary and mandibular prominences , 706 Dissociated horizontal deviation (DHD) , 605 nasolacrimal groove forms , 706 Dissociated strabismus complex (DSC) , 605 neonatal calvarium , 707 Dissociated torsional deviation (DTD) , 605 nonsyndromic , 707–708 Dissociated vertical deviation (DVD) , 484 , 585 ophthalmic sequelae , 705 anti-elevation syndrome , 607 pediatric skull and cranial sutures , 707 DHD and DTD , 605 Pfeiffer syndrome , 712 elevation movement , 605 Saethre–Chotzen syndrome , 710 , 711 Hering’s Law , 605 skull/neurocranium , 707 high-grade fusional mechanisms , 606 syndromic craniosynostosis and ophthalmic considerations , 708 hypertropia , 605 transgenic animal models , 707 infantile esotropia , 606 Virchow’s law , 707 inferior oblique , 606 Craniosynostosis syndromes , 584 latent nystagmus , 606 Crouzon syndrome , 709–710 , 716 , 720 quantitative measurements , 606 Cruz, O.A. , 570 , 573 refi xation movements , 606 Cryotherapy surgical management , 606 retinoblastoma , 390 treatment , 606 Cryotherapy for retinopathy of prematurity (CRYO-ROP) , 302 visual axis , 605 CSD . See Cat-scratch disease (CSD) DON . See Demyelinating optic neuritis (DON) CSM . See Central, steady, and maintained (CSM) Dosso, A.A. , 105 CSNB . See Congenital stationary night blindness (CSNB) Dosunmu, E.O. , 439–455 , 457–465 CSuM . See Central, steady, and unmaintained (CSuM) Double Maddox rod test Cyclodialysis cleft , 307 , 309 cyclodeviation , 20 Cycloplegia , 761 excyclodeviation , 20 Cystoid macular edema (CME) , 216 , 224 incyclodeviation , 20 Cytomegalovirus (CMV) , 119 , 244 Down syndrome (DS) , 501 accommodation insuffi ciency , 740 behavioral/tactile sensory , 741 D brushfi eld spots , 735 , 736 4 Δ base-out prism test , 32 cataracts , 737 , 738 Dacryocystitis , 655 , 656 cognitive disabilities , 735 Dal Canto, A.J. , 563 , 571 , 575 cycloplegia , 741 Davitt, B.V. , 573 esotropia , 737 Dawson, E. , 625 excimer laser keratorefractive procedures , 741 de Haas, V. , 412 eyelid and orbit , 739 de Morsier syndrome , 396 genetics , 736 De novo , 335 glasses , 741 Deacon, B.S. , 183–189 glaucoma , 739 Del Monte, M.A. , 495–497 , 499–502 , 613 , 614 , 616–621 head-tilt esotropia , 736 Demyelinating optic neuritis (DON) , 431–436 , . See also Ancillary intellectual disability , 735 ophthalmic testing keratoconus , 738–739 with abnormal brain MRI , 437 management , 741 diagnostic criteria , 430 Mohindra retinoscopy , 741 Index 805

myopia , 739 diagnosis , 201 nasolacrimal system obstruction , 739 endocapsular/extracapsular techniques , 207 nystagmus , 737–738 iridodonesis , 201 palpebral fi ssure , 735 , 740 lens dislocation , 207 pediatric/general ophthalmologist , 742 Marfan syndrome , 201 , 202 person-fi rst language , 742 medical management , 206–207 refractive correction , 741 molybdenum cofactor defects and sulfi te oxidase defi ciency , 205 refractive errors , 739–740 OD>OS , 201 , 202 screening , 741–742 phakic and aphakic refraction , 207 strabismus , 736–737 pupils , 202 torticollis , 739 subluxated lenses , 199 , 207 Down, J.L. , 735 , 739 subluxation lenses , 202 DSAEK . See Descemet stripping automated endothelial keratoplasty sulfate metabolism , 199 (DSAEK) Traboulsi syndrome , 202 DSC . See Dissociated strabismus complex (DSC) WMS , 199 DTD . See Dissociated torsional deviation (DTD) zonule , 199 Duane retraction syndrome , 507 Ectopia Lentis et Pupillae , 202 amblyopia , 550 Eisenberg, M.A. , 613 , 614 , 616–621 autopsy , 547 El-Dairi, M.A. , 271–275 , 277 , 281 , 283–285 , 287 , 427–431 , 433 , bilateral medial rectus recession , 552 435–437 concomitant recession, superior rectus muscles , 552 Electroretinography (ERG) congenital cranial dysinnervation disorder , 548 anesthesia , 293 diagnosis , 550 Burian-Allen electrodes , 293 electromyography , 548 cone dysfunction , 295 esodeviation , 553 Dawson-Trick-Litzkow (DTL) , 293 esotropia , 548 electrodes and light stimulus , 293 examination , 550–551 Ganzfeld stimulator , 291 exotropia , 548 Hawlina-Konec electrode (HK) , 293 genetics , 550 , 551 indications , 291–293 horizontal muscle resection , 552 LCA and RP , 295 ipsilateral recession, single rectus muscle , 551–552 photovoltaic effect , 293 management , 550–552 protocol , 293 Marcus Gunn Jaw-Winking , 549 retinal dystrophies , 291 , 292 nonsurgical management , 551 rod dysfunction , 293–295 occlusive penalization therapy , 554 skin corneal/skin electrodes , 291 orthophoria , 553 waveform morphologies , 293 strabismus , 550 Ellis, F.D. , 569 surgical management , 551–552 Ellis, F.J. , 659–664 types , 548–550 Ellis, G.S. Jr. , 3–15 , 17–23 , 500 unilateral recession, medial and lateral rectus muscles , 552 Ellsworth, R. , 384 vertical muscle transpositions , 552 Embryology , 193–194 Duane syndrome , 484 Encephalofacial angiomatosis , 372 Duction test Endogenous endophthalmitis , 245 Brown syndrome , 17 Endophthalmitis , 642 , 644 limitations, movement , 17 Endophytic tumors , 369 Duncan, J.E. , 271–275 , 277 , 281 , 283–285 , 287 Endotheliitis , 124 Dunn, W.J. , 567 Enhanced depth imaging (EDI) , 272 Dupps, W.J. , 129–133 Enophthalmos , 675 Durairaj, V.D. , 676 Enucleation DUSN . See Diffuse unilateral subacute neuroretinitis (DUSN) retinoblastoma , 387–388 DVD . See Dissociated vertical deviation (DVD) Enzyme-linked immunoassay (ELISA) , 234 Dynamic retinoscopy EOMs . See Extraocular muscles (EOMs) hypo-accommodative ability , 765 Epidemic keratoconjunctivitis (EKC) indications , 765 adenovirus , 105 technique , 765–766 confocal microscopy , 105 Dysinnervation , 659 punctate keratopathy , 105 steroids , 105 subepithelial infi ltrates , 105 E symptoms , 105 E.O.M. . See Extraocular muscles (E.O.M.) viral conjunctivitis , 105 Early treatment for ROP (ETROP) , 302 Epiretinal membranes (ERMs) , 224 , 366 , 367 Ectopia lentis , 200–201 Epithelial keratitis , 121–122 ADAMTSL4 , 202 Escott, S.M. , 233–245 amblyopia , 202 Esotropia , 548 axial myopia, cataract and retinal detachment , 202–203 Estimated gestational age (EGA) , 301 craniofacial dysostosis , 205 Exam under anesthesia (EUA) , 656 806 Index

Examinations under anesthesia (EUAs) , 458 neurologic/ocular causes , 748 Excimer laser treatment , 75 , 76 Fusional vergence amplitude testing Exophthalmometry , 675 amblyoscope , 18 Exophytic lesions , 370 deviations , 19 Exotropia , 526 prism amount , 19 clinical evaluation , 536–537 single binocular vision , 18 exophoria , 535 infantile exotropia , 535 , 536 intermittent , 537 G intermittent exotropia , 536 Gair, E.J. , 567 lazy left eye infant , 542–544 Ganglion cell layer-inner plexiform thickness (GCL-IPL) , 363 minus lens therapy , 537–538 Gappy, C. , 479 , 480 , 484–486 occasional drifting , 539 , 540 Garcia, G. , 669 outward drifting , 540–542 Gardner Syndrome , 372 part-time occlusion , 537 GCS . See Glasgow Coma Score (GCS) pseudoexotropia , 535 Gene Tests , 380 sensory , 536 Genetic counseling surgical intervention , 538 , 539 Axenfeld–Rieger syndrome , 332 Extraocular muscle entrapment , 676 , 678 bilateral Legg–Calve–Perthes disease vs . multiple epiphyseal Extraocular muscles (EOMs) , 526 , 624 dysplasia , 332 CFEOM1 , 594 comparative genomic hybridization (CGH) , 332 CFEOM2 , 594 dysplasia , 332 CFEOM3 , 594–595 fundus and optic nerve , 332 unilateral/bilateral involvement , 594 healthcare professionals , 331 process , 331 Genetic testing F AAO , 331 F D T . See Forced duction testing (FDT) AAP and ACMG , 331 F A F . See Fundus autofl uorescence (FAF) achromatopsia , 333 , 334 Faivre, L. , 203 amblyopia , 333 Familial adenomatous polyposis (FAP) , 372 CLIA , 329 Familial exudative vitreoretinopathy (FEVR) , 195 , 355 CMA , 331 Farkas, L.G. , 713 CMS , 329 Feldon, S.E. , 561 cost , 329–330 FEVR . See Familial exudative vitreoretinopathy (FEVR) EFEMP3 causes , 330 FGFR . See Fibroblast growth factor receptors (FGFR) family history , 330–331 Fibroblast growth factor receptors (FGFR) , 707 fundus images , 334 , 335 Fibrosis of extra-ocular muscles , 632 juvenile X-linked retinoschisis , 333 Fisher, M.J. , 363 , 412 , 413 laboratory reputation , 330 Fluorescein angiography , 382 microarray , 330 Fluorescein angiography (FA) , 262 , 263 , 265 NGS , 330 FMNS . See Fusion maldevelopment nystagmus syndrome (FMNS) nystagmus , 333 Forced duction testing (F.D.T.) , 627 predictive genetic testing , 331 Foster, J. , 705–708 , 710 , 712–716 PS and KSS , 334 Foster, R.S. , 509 , 552 retinal dystrophy , 333 Foveal hypoplasia , 285 turnaround time , 330 Freedman, S.F. , 271–275 , 277 , 281 , 283–285 , 287 , 439–455 , 457–465 WES , 330 Frontalis sling , 527 Ghasia, F.F. , 81–97 , 747–752 Fuchs heterochromic iridocyclitis (FHI) , 244 Gigliotti, F. , 104 Fundus autofl uorescence (FAF) , 265 Glasgow Coma Score (GCS) , 316 Fundus camera , 263 Glaucoma , 151 , 273–274 , 739 Fungal keratitis , 113 , 114 Goldberg, M.F. , 191 corneal perforation , 114 Goldenhar syndrome , 713 diagnosis , 113 Goldman, R. , 669 pathogenesis , 113 Goldmann visual fi eld testing , 431 risk factors , 113 Goldstein, D.A. , 233–245 treatment Goniotomy , 441 , 444 , 452 , 454 amphotericin B , 113 Gonococcal conjunctivitis , 107 epithelial toxicity , 114 Gradenigo’s syndrome , 508 polyenes , 113 Graves disease , 687 Fusion maldevelopment nystagmus syndrome (FMNS) Gray, M.E. , 167–171 Alexander’s law , 748 Greenberg, M.F. , 552 blockage syndrome , 749 Greenstick fracture . See Trapdoor fractures defi nition , 748 Gregg, F.M. , 95 eye movements , 748 Group A retinoblastoma , 390 fogging technique , 749 Group C retinoblastoma , 391 Index 807

Group D retinoblastoma , 389 algorithm, evaluation and management , 40 Gu, S. , 363 amblyopia and strabismus , 39 Gupta, N. , 161 combination , 37 Guyton, D.L. , 614 correction , 42 cycloplegic refraction , 39 cycloplegic refractive errors , 38 H esodeviation , 37 Hanson, L L. , 175–181 esotropia , 37 Haploscopic tests , 33 moderate levels , 38 Harada , 229 outcomes , 38 , 42 Harley, R.D. , 750 PEDIG , 39 Harris, G. , 669 prescribing practices and screening guidelines , 38 Harrison, D.A. , 207 prescription , 39 Harvey, E.M. , 38 refractive correction , 38 Hatt, S.R. , 537 retinoscopy , 39 HEDS . See Herpetic Eye Disease Study Group (HEDS) strabismus and amblyopia , 37 Heidary, G. , 407–413 visual acuity Hemangioblastomas amblyopia , 41 retinal and optic nerve head , 369–370 central, steady and maintained (CSM) , 39 Hematologic tumors CSM OU , 39 histiocytic , 694–695 high hypermetropia with pseudoesotropia , 41 leukemia and lymphoma , 694 isolated bracketed HOTV , 41 , 42 xanthogranuloma , 695 management options , 39 , 41 Hemifacial microsomia , 713 , 715–716 single optotype , 41 Hemizygous , 335 Hyphema , 242 , 254 Herpes simplex keratouveitis , 240–241 clinical features , 150 Herpes simplex virus (HSV) complications , 149 , 151 anterior segment , 120 examination , 152 blepharoconjunctivitis and periocular disease , 120–121 injury , 150 endotheliitis , 124 management , 152 epithelial keratitis , 121–122 medical management , 150 , 151 herpetic disease , 120 pathophysiology , 150 iritis , 124–125 sickle cell trait , 152 neonatal ocular , 125 surgical management , 151 stromal keratitis , 122–124 trauma , 149 Herpes simplex virus-1 (HSV-1) , 114 Hypotropia , 526 Herpes zoster ophthalmicus (HZO) , 242 HZO . See Herpes zoster ophthalmicus (HZO) Herpetic Eye Disease Study Group (HEDS) , 120 Herring’s Law , 8–9 Hertle, R.W. , 710 I Hess, R.F. , 96 Iannaccone, A. , 411 Heterochromia , 254 ICGA . See Indocyanine green angiography (ICGA) Heterozygous , 335 Idiopathic intermediate uveitis , 224 Hirschberg method , 14 Idiopathic intracranial hypertension . See Pediatric pseudotumor Histoplasmosis , 244–245 cerebri syndrome (PTCS) Homocystinuria , 204–205 Immunomodulatory therapies (IMT) , 223 Homozygous , 335 Incomitant strabismus , 636 , 639 Hood, C.T. , 109–116 Incontinentia pigmenti , 356 Horizontal muscle displacement/transposition , 588 Indocyanine green angiography (ICGA) , 265 Horner syndrome , 661 Infant Aphakia Treatment Study (IATS) , 96 , 458 Hubel, D.H. , 82 Infantile cataracts , 183 , 186–188 Human Adenovirus Working Group , 104 evaluation , 175 , 177 , 178 Humphrey visual fi eld (HVF) , 431 familial bilateral congenital cataracts , 179 , 180 Humphrey Visual Field 24-2 SITA Standard , 473 , 474 informed consent , 189 Hung-up syndrome , 628 , 630 inherited causes , 175–177 Hutcheson, K.A. , 502 parental counseling , 189 H V F . See Humphrey visual fi eld (HVF) pediatric (see Pediatric cataracts ) Hyperdeviations post-surgical issues hypertropia , 610 age and surgical timing , 187 incyclotorsion , 610 posterior capsule opacifi cation , 188 inferior oblique overaction , 608 surgical technique , 187 , 188 skew deviation , 610 surgery superior oblique muscle , 610 morphology , 187 Hyperlysinemia , 205 surgical intervention , 186 , 187 Hypermetropia in infancy , 39 , 41 , 42 systemic disorders , 180–181 AAPOS , 39 systemic evaluation , 177 AAPOS survey , 38 unilateral congenital cataract , 178 , 179 808 Index

Infantile esotropia , 485 , 486 history and examination , 675 algorithm , 486 ophthalmic examination , 675 (see also Pediatric orbital fl oor amblyopia , 485 fractures) binocular vision , 479 , 480 surgical intervention , 676 CEOS , 484 trauma , 675 Chavasse’s theory , 480 Infl ammatory lesions cross fi xation , 479 nonspecifi c orbital infl ammation , 685–686 DVD , 484 ruptured dermoid cyst , 687–688 eye fi xating and left eye deviating , 481 thyroid eye disease , 686–687 IOOA , 484 Informed consent Krimsky method , 484 , 485 advantages , 189 latent nystagmus , 484 amblyopia therapy , 189 management , 485 cataract surgery , 189 monofi xation syndrome , 480 implantation , 189 ophthalmic examination , 484 optical rehabilitation , 189 refractive errors , 484 pediatric cataract surgery , 189 right esodeviation and hypertropia , 483 , 484 unilateral infantile cataracts , 189 smooth pursuit asymmetry , 484 Infrared imaging , 265 strabismus , 479 Ingram, R.V. , 37 treatment INS . See Infantile nystagmus syndrome (INS) bilateral medial rectus recessions/unilateral recess–resect Insulin-like growth factor 1 (IGF-1) , 300 procedure , 485 Intermittent exotropia , 535–537 , 539 botulinum toxin , 485 Intermittent exotropia control scale (IXTCS) , 537 CEOS , 485 International Classifi cation for ROP (ICROP) , 300 orthotropia , 485 International League of Associations for Rheumatology (ILAR) , 213 strabismus , 486 International Society for Clinical Electrophysiology of Vision Worth’s sensory theory , 479 (ISCEV) , 293 Infantile hemangioma , 689 Intraocular foreign body (IOFB) , 308 Infantile nystagmus syndrome (INS) Intraocular lens (IOL) , 216 defi nition , 749 Intraocular pressure (IOP) , 457 eye positions , 750 corneal blood staining , 151 foveal morphology , 750 elevation , 151 FRMD7 gene , 751 injury , 150 head oscillations , 750 traumatic hyphema , 150 Kestenbaum procedure , 750 , 751 Intraoperative relaxed muscle technique , 570 OCT , 751 Intraoperative relaxed muscle technique (IRMT) structural eye abnormalities , 751 contralateral eye , 570 vertical rectus muscles , 751 cross-swords technique , 570 Infectious endophthalmitis , 245 diplopia , 571 Infectious uveitis , 233–245 distal rectus tendon , 570 bacterial inferior rectus recession , 571 CSD , 239 Westcott scissors , 570 intraocular tuberculosis , 240 IOFB . See Intraocular foreign body (IOFB) Lyme disease , 239 , 240 IOOA . See Inferior oblique overaction (IOOA) syphilis , 238–239 I O P . See Intraocular pressure (IOP) fungal Iridodonesis , 201 endogenous endophthalmitis , 245 Iris hamartomas (Sakurai-Lisch nodules) , 360 , 363 histoplasmosis , 244–245 Iritis , 124–125 parasitic Irregular astigmatism DUSN , 237 conditions , 51 toxocariasis , 236–237 corneal or lenticular , 51 toxoplasmosis , 233–235 corneal scarring , 55 , 56 viral corneal topography , 51 CMV , 243 , 244 diagnosis , 51 herpes simplex keratouveitis , 240–241 Keratoconus suspect , 54 , 55 necrotizing retinitis , 242–243 Marfan syndrome , 57 Rubella , 244 ISCEV . See International Society for Clinical Electrophysiology of VZV , 241 , 242 Vision (ISCEV) Inferior oblique overaction (IOOA), 484 , 606 Isenberg, S.J. , 500 hypertropia , 608 IXTCS . See Intermittent exotropia control scale (IXTCS) infantile esotropia , 607 superior oblique muscle , 608 superior oblique palsy , 608 J Inferior Oblique Palsy , 627 Jain, A. , 668 Inferior orbital wall fractures Janse, A.J. , 366 enophthalmos , 675 Joseph, D.P. , 169 entrapped and non-entrapped , 676 Jotterand, V.H. , 500 Index 809

Juthani, V. , 129–133 sensorimotor , 470 Juvenile (psammomatoid) ossifying fi broma , 697 Tono-Pen® , 470 Juvenile idiopathic arthritis (JIA) , 216 , 217 treatment , 470 abatacept , 220 Juvenile ossifying fi broma , 698 adalimumab , 219 Juvenile xanthogranuloma (JXG) , 253–255 adherence , 216 Juvenile X-linked retinoschisis , 278 biologic agents , 219 cataract , 217 children and adolescents , 215 K classifi cation , 213 , 214 Kasabach–Merritt syndrome , 690 complications , 214 Kaufman, A.H. , 119–127 etanercept , 219 Kaufman, A.R. , 119–127 eye infl ammation , 214 Kazim, M. , 560 folinic acid , 219 Kearns–Sayre syndrome (KSS) , 334 golimumab , 219 Kekunnaya, R. , 552 IL-1 inhibitors , 219 Kelly, J.P. , 412 IL-6 inhibitors , 220 Keratoconus , 738–739 ILAR , 213 Kerr, N.C. , 559–564 , 566–571 , 573 , 575 , 577 immunomodulators , 219 Kestenbaum procedure , 750 , 751 infl iximab , 219 Kestenbaum, A. , 750 methotrexate and adalimumab , 217 Khan, A.O. , 202 , 507 methotrexate therapy , 217 Kim, S.H. , 400 MTX , 217 Kim, T. , 155–165 multidisciplinary approach , 216 Kivlin–Krause syndrome , 135 OCT , 217 Knapp procedure , 527 ocular complications Knox, D.L. , 507 band keratopathy , 216 Knudson, A.G. , 379 , 380 cataracts , 216 Kovarik, J.J. , 605 , 606 , 608 , 610 CME , 216 Koyanagi , 229 cystoid macular edema , 217 Kraft, S.P. , 552 IOL , 216 Kraus, C.L. , 183–189 macular edema , 216 Krimsky method , 14 , 485 microvascular factors , 217 Kuhn, F. , 167 viscoelastic , 216 Kumar, P. , 191 , 193–197 , 379–391 pathogenesis , 214 Kushner, B.J. , 500 pediatric age group , 213 pediatric rheumatology and ophthalmology community , 220 rituximab , 220 L SD-OCT , 218 Laithier, V. , 412 short-term and long-term functional outcomes , 215 Lam, G.C. , 86 sustained-release dexamethasone implant , 217 , 218 Langerhans cell histiocytosis (LCH) TNF-α , 219 classifi cation , 694 tocilizumab , 220 histiocytic vascular infi ltrate , 694 treatments , 215 LaRoche, G.R. , 489–493 uveitis , 214–216 Laser therapy Juvenile open-angle glaucoma (JOAG) retinoblastoma , 390 anterior segment , 471 LASIK , 75 automated visual fi eld testing , 470 Latent deviations cycloplegic refraction , 472 detection , 10–11 diagnosis , 472 vs . manifest deviations , 11–12 diagnosis and management algorithm , 470 , 471 measurement , 11 follow-up examination , 472 Latent nystagmus , 748–749 genetic testing , 470 LCA . See Leber congenital amaurosis (LCA) glaucoma , 469 Leber congenital amaurosis (LCA) , 281–283 , 295 , 345–348 GLC1 , 469 Leber’s hereditary optic neuropathy (LHON) , 760 gonioscopy , 469 Lee, J. , 507 , 625 IOP , 470 Leigh, R.J.Z.D. , 752 myopia , 469 Lens opacity , 177 OCT , 470 Leukemia , 253 optic nerve cupping OU , 470 Leukocoria , 381 , 386 pachymetry , 471 Levodopa , 94 pertinent examination , 472 LHON . See Leber’s hereditary optic neuropathy (LHON) planning , 472 Lim, S.A. , 760 posterior segment , 471 Limbal stem cell defi ciency (LSCD) postoperative follow-up appointment (2 months) , 472–474 corneal scarring , 164 postoperative follow-up appointment (one-week) , 472 fi lamentary keratitis , 164 810 Index

Lin, J. , 291 , 293 , 295 leukemia , 253 Lindquist, T.P. , 505–510 lymphoma , 253 Liu, G.T. , 418–424 retinoblastoma , 251 , 252 Logarithm of minimal angle of resolution (logMAR) , 5 nonmalignant logMAR . See Logarithm of minimal angle of resolution (logMAR) JXG , 253 , 254 Longmuir, S.Q. , 316 occult intraocular foreign bodies , 255 Loose lenses vs . phoropter , 761 orbital pseudotumor , 255 Lowder, C. , 213–217 , 219 , 220 , 251 , 253–256 retinal detachment , 255 Low-fl ow malformations (LFMs) Mazow, M.L. , 569 distensible , 693 McCormack, S.E. , 418–424 lymphatic dominant LVMs (LD-LVMs) , 692 McGregor, M.L. , 719 , 720 , 722 nondistensible , 691 , 693 McKeown, C.A. , 641–646 venous dominant LVMs (VD-LVMs) , 692 Medina, C.A. , 379–391 LSCD . See Limbal stem cell defi ciency (LSCD) Meghpara, B. , 243 Lueder, G.T. , 569 , 577 Mehendale, R.A. , 552 Lusk, K. , 725 , 726 , 731–733 Mesenchymal tumors Lyme disease fi bro-osseous tumors , 697 , 698 bilateral keratitis , 239 leiomyoma , 698 diagnosis , 239 , 240 orbital rhabdomyosarcoma , 695 , 697 mild conjunctivitis , 240 Metabolic disorders , 175 , 180 retinal vasculitis , 239 Microcephaly , 353 , 356 stages , 239 Microphthalmos , 381 Lymphoma , 253 Microspherophakia , 203 Lyons, S.A. , 38 Mikaeloff, Y. , 433 Miller, J.E. , 568 Miller, J.M. , 38 M Miller, N. , 526 , 527 Maddox rod test Miyake, N. , 550 advantage , 13 Möbius syndrome , 506 , 507 , 600 prim bar/rotary prism , 13 Moffatt, M.E. , 313–318 strabismus , 12 MOG . See Myelin-oligodendrocyte glycoprotein (MOG) antibodies Mahoney, N.R. , 507 Mondok, L. , 757–760 Malalis, J.F. , 233–245 Moreno, L. , 413 Malformations , 395 Morning glory disc anomaly (MGDA) , 396–399 optic nerve (see Optic nerve malformations ) Mosaic Down syndrome (MDS) , 736 Malingering Motley, W.W. , 179 , 181 , 735–737 , 739–742 after eye trauma , 759 Motor fusion test vision loss , 757 fusional vergence amplitude testing , 18–19 Manifest deviation NPC , 19 detection , 9–10 Mourits, M.P. , 563 vs . latent deviation , 11–12 Multiple evanescent white dot syndrome (MEWDS) , 268 measurement , 10 Multiple sclerosis (MS) Mantyjarvi, M.I. , 758 CIS study , 433 Marcotty, A. , 535–537 , 539–543 , 651 , 652 , 654–656 diagnosis , 433 Marfan syndrome MRI , 431 amblyopia , 203 pediatric DON studies , 433 beta-blocking agents , 204 risk of , 433 corneal curvature , 203 Myasthenia gravis FBN1 molecular testing , 203 globe retraction , 638 fi brillin 1 , 203 hospital course , 638–639 fi brillin fi bers , 203 myasthenia gravis (MG) , 638 infants and children , 204 Myelinated nerve fi bers , 404–405 keratometry and CCT values , 203 Myelin-oligodendrocyte glycoprotein (MOG) antibodies , 431 kyphoscoliosis , 203 Myopia , 47 , 48 lens extraction , 204 axial , 45 , 46 Losartan® , 203 control groups , 48 microspherophakia , 203 growth and development, human eye , 46 open angle glaucoma , 204 management stretched and rarifi ed zonules , 203 , 204 cycloplegic refraction , 48 subluxation lens , 203 differential diagnosis , 47 transforming growth factor-beta neutralizing antibodies/losartan , low-grade , 48 203 progression , 48 Marfan, A. , 203 retinoscopy , 48 Marino, M.J. , 329–336 surgical refractive procedures , 48 Masquerade syndromes , 251–255 symmetrical and uncorrected , 48 diagnostic algorithm , 257 young children , 48 malignant mild , 47 Index 811

myopic correction , 45 intracranial mass/stroke , 517 ocular and systemic conditions , 46–47 ipsilateral inferior oblique recession , 517 prevalence , 45 Knapp classifi cation , 515 prevention , 48 motor nerve , 513 refractive , 45 , 46 muscle surgery , 516 retinopathy, moderate , 47 ocular movements , 516 school-aged , 48 physical therapy , 514 Stickler syndrome , 47 , 48 sports-related head injury , 521 uncorrected myopic eye’s focal point , 45 superior oblique , 516 Myotonic dystrophy , 661 superior oblique traction test , 515 Surgical management , 516 three-step Parks-Bielschowsky test , 514 N torsion , 521 Nabavi, C. , 705–708 , 710 , 712–716 torticollis , 514 , 517 Nasolacrimal duct obstruction (NLDO) , 652–655 , 712 trauma , 517 , 519 amblyopia , 651 trochlear nerve , 513 congenital glaucoma , 651 , 652 , 656 vertical fusional amplitudes , 517 congenital tear duct obstruction , 651 , 652 , 656 Neural tumors corneal abrasion , 651 , 652 optic nerve glioma , 688–689 dacryocystitis , 655 , 656 optic nerve sheath meningioma , 689 epiphora , 651 , 652 , 657 orbital schwannomas , 689 management Neurofi bromatosis type 1 (NF1) , 407 congenital dacryocystocele , 654 , 655 characterization , 359 epiphora , 654 diagnosis , 411 NLD compression , 652 , 653 features , 410 ocular adnexa , 652 iris hamartomas (Sakurai-Lisch nodules) , 360 , 363 offi ce vs . operating room , 654 OPG , 360–364 , ( see also Optic pathway gliomas (OPG) ) surgical outcomes , 654–655 orbitotemporal neurofi bromas (plexiform neurofi bromas) , 360 , 364 Pediatric Eye Disease Investigator Group , 652 pVEPs , 411 tearing , 651 tissue defi nitions , 360 Nasolacrimal system obstruction , 739 Neurofi bromatosis type 2 (NF2) Natan, K. , 551 case study , 365 National Center for Biotechnology Information (NCBI) , 330 cataracts , 366 National Child Abuse and Neglect Data System (NCANDS) , 313 characterization , 364 National Society of Genetic Counselors , 380 diagnostic criteria , 364 NCANDS . See National Child Abuse and Neglect Data System mild [Gardner] subtype , 364 (NCANDS) ophthalmologic fi ndings , 365 NCBI . See National Center for Biotechnology Information (NCBI) severe [Wishart] subtype , 364 NCS . See Newcastle control score (NCS) Neurogenic esotropia Near point of convergence (NPC) afferent defects and strabismus , 490–491 diplopia , 19 children , 489 , 490 fusional convergence amplitude testing , 19 descriptions , 489 Necrotizing retinitis , 242–243 dilation and cycloplegic refraction , 493 ARN , 242 diplopia , 490 , 493 Neonatal conjunctivitis , 103 efferent defects and strabismus , 491 chemicals , 107 hyperopia , 490 chlamydia , 107 MRI , 490 erythromycin , 107 myopia , 492 gonorrhea , 107 neuroimaging investigations , 489 N. gonorrheae , 107 neuromotility assessment , 491 Neisseria , 107 nystagmus , 492 ophthalmia neonatorum , 107 ophthalmoscopy , 492 pathogens , 107 PD , 492 perinatal transmission , 107 posterior fossa medulloblastoma , 493 prophylaxis , 107 sensory adaptation testing and neurologic examination , 493 Nerve palsy, children strabismus , 489 , 493 amblyopia , 515 suppression , 492 , 493 bilateral palsy , 517 Neuromyelitis optica (NMO) Brown syndrome , 516 antibodies , 431 congenital cases , 513 description , 430 diplopia , 517 diagnostic criteria , 433 esodeviation , 516 DON with suspected , 437 excyclotorsion , 514 , 517 , 519 in females , 433 facial asymmetry , 514 MOG antibodies , 433 fundus torsion , 516 neurologic symptoms , 433 hypertropia , 513 , 516 Neuro-ophthalmologic fi ndings , 366 hypertropias , 517 Neuroretinitis , 239 , 274 812 Index

Newcastle control score (NCS) , 537 inferior oblique muscle , 584 , 587 Next-generation sequencing (NGS) , 330 , 335 inferior rectus muscle , 584 , 588 NGS . See Next-generation sequencing (NGS) inferotemporal fornix incision , 584 , 585 Nguyen, V.T. , 570 intermuscular septum , 584 , 586 Nicholson, B.P. , 563 , 570 , 571 , 573 superior oblique muscle , 585 , 586 Nicolin, G. , 412 Occult intraocular foreign body , 255 NLDO . See Nasolacrimal duct obstruction (NLDO) O C T . See Optical coherence tomography (OCT) NMO . See Neuromyelitis optica (NMO) Octopus visual fi eld analyzer (Haag-Streit AG) , 431 Non-entrapped fractures , 676 Ocular chemical injury , 161–163 Non-ocular tumors acids , 159 retinoblastoma , 383 acute management , 155 , 156 Nonorganic visual loss (NOVL) alkali , 159 anxiety-inducing factors , 758 classifi cation , 156 , 157 , 160 , 161 binocular and monocular , 759 corneal opacifi cation , 164 clinicians , 760 corneal opacity , 156 diagnostic testing , 759 cycloplegic refraction , 156 fogging test , 759 early management , 156 , 157 functional visual loss , 758 emergency department , 156 groups , 757 epidemiology , 158 , 159 hysterical amblyopia , 758 limbal stem cell defi ciency , 164 management , 760 long-term management , 157 , 158 psychogenic amblyopia , 758 medical treatment Titmus stereo test , 759 acetazolamide , 163 visual conversion disorder , 758 amniotic membrane grafting , 162 visual disturbance , 758 beta-adrenergic antagonists , 163 visual fi eld testing , 759 carbonic anhydrase inhibitors , 163 Nonspecifi c orbital infl ammation (NSOI) , 685 corneal epithelium , 161 biopsy , 686 corticosteroids , 161 differential diagnosis , 685 cyclomydril , 163 pediatric , 685 , 686 cycloplegic agents , 163 Nonsteroidal anti-infl ammatory drug (NSAID) , 217 epithelial defect , 162 Non-treponemal tests , 238 infl ammatory reaction , 161 Normal retinal correspondence (NRC) liquid formulations , 162 exotropia , 32 management , 162 fusional vergence , 27 punctal occlusion , 163 Norrie disease , 195 , 355 safety and effi cacy , 161 NOVL . See Nonorganic visual loss (NOVL) stages, corneal wound healing , 162 NPC . See Remote near point of convergence (NPC) systemic ascorbate , 162 Nucci, P. , 251 , 253–256 tetracyclines , 163 Nystagmus , 737–738 , 748–751 phone call , 155 and eye movement abnormalities , 747 , 749 sequelae and surgery , 163–165 classifi cation , 748 signs and symptoms , 159 , 160 conjugate/disconjugate , 747 Ocular dominance columns , 82 corrective/abnormal eye movement , 747 Ocular fl utter , 752 esotropia , 23 Ocular rosacea , 115 eye movement recordings , 22 Ocular toxocariasis , 195 , 236 , 237 eye positions , 748 , 749 Ocular toxoplasmosis , 234 , 235 INS (see Infantile nystagmus syndrome (INS) ) Ocular trauma scores (OTS) , 167 , 168 , 307 latent nystagmus (see Fusion maldevelopment nystagmus O'Doherty, M. , 356 syndrome (FMNS)) Olitsky, S.E. , 505–510 ocular and neurologic conditions , 23 Open globe injury , 167–169 ocular fl utter , 752 Ophthalmic abnormalities oculomotor apraxia , 23 amblyogenic ametropia/anisometropia , 713 opsoclonus , 752–753 amblyopia , 713 pediatric ophthalmology practice , 747 amblyopia and strabismus , 713 retinal electrophysiologic testing , 748 chronic corneal exposure , 714 spasmus nutans , 751 craniofacial deformity , 713 vertical nystagmus in infancy , 751–752 craniofacial disorders , 713 voluntary , 753 craniofacial surgeries , 715 Nystagmus blockage syndrome , 749 craniosynostosis/clefting syndrome , 713 dacryocystitis , 714 dye disappearance test , 714 O exophthalmometry , 714 Oblique muscle overaction , 584 lacrimal outfl ow system , 715 Oblique muscle surgery measurement , 713 anterior and posterior borders , 584 , 585 nasolacrimal duct stenosis , 714 anteriorization/anterior transposition , 585 oculoplastic , 715 Index 813

Opremcak, E.M. , 223 , 224 , 226–230 Optical coherence tomography (OCT) , 217 , 272 , 274 , 275 , 277–286 , 441 Opsoclonus , 752–753 AS-OCT , 285 Optic disc drusen , 402–404 atrophic nerves Optic nerve , 472–474 compressive lesions , 275 Optic nerve coloboma , 398–400 papilledema , 275 Optic nerve edema RNFL , 274 , 278 neuroretinitis , 274 , 277 bioptigen , 285 optic neuritis , 274 , 277 chiasmal glioma , 279 papilledema , 274 , 276 genetic retinopathies Optic nerve head drusen , 274 batten disease , 283–285 Optic nerve hypoplasia (ONH) , 275–277 choroideremia , 283 , 284 de Morsier syndrome , 396 cone rod dystrophy , 278–282 defi nition , 395 foveal hypoplasia , 285 , 286 different pathways and timing in eye development , 396 , 398 juvenile X-linked retinoschisis , 278 , 281 double-ring sign , 395 , 396 leber congenital amaurosis , 281–283 genetic and environmental associations , 395 , 396 , 398 pseudohypopyon , 283 hypopituitarism , 396 rod cone dystrophy , 283 OCT , 395 , 397 RPE/photoreceptor changes , 277 prevalence , 395 Stargardt disease , 277–278 , 281 septo-optic dysplasia , 396 vitelliform dystrophy , 283 tortuosity of retinal veins , 395 , 396 glaucoma , 273–274 Optic nerve malformations noninvasive imaging technology , 271 clinical associations , 404 , 405 optic nerve edema , 274 MGDA , 396–399 optic nerve head drusen , 273 , 274 myelinated nerve fi bers , 404–405 optic nerve head map , 273 ONH , 395 , 396 optic nerve head scan , 274 optic disc drusen , 402–404 optic nerve hypoplasia , 275–277 , 280 optic nerve coloboma , 398–400 optical waves , 271 optic pit , 399–401 retinal nerve fi ber layer , 275 papillorenal syndrome , 399 retinal scans peripapillary staphyloma , 400–402 EDI , 272 tilted disc syndrome , 401–402 high-resolution scans , 272 Optic neuritis , 274 macular maps , 272 Optic neuritis in children , 430 retinitis pigmentosa , 284 differential diagnosis , 427 , 428 retinopathy , 285 , 287 DON (see Demyelinating optic neuritis (DON) ) RNFL , 273 fl uorescein angiogram , 429 vitelliform dystrophy , 283 grade 2 swelling, optic nerve , 427 , 428 Orbital abscess history, case study , 427 imaging, role of , 668 neuroretinitis with , 429 with/without intracranial complications , 668 Optic neuropathy , 561 Orbital cellulitis Optic pathway gliomas (OPG) , 751 defi nition , 667 BCH , 410 ethmoid and maxillary sinuses , 668 (see also Periocular infections ) classifi cation , 410 polymicrobial , 668 clinical synopsis , 407–410 symptoms , 667 diagnosis , 410 , 411 , 413 treatment of , 669 differentiate NF1-associated and non-NF1-associated , 410 Orbital pseudotumor , 255 GCL-IPL , 363 Orbital retinoblastoma , 699 guidelines , 363 Orbital rhabdomyosarcoma low-grade designation , 410 grouping of , 697 low-grade neoplasms , 407 Orbitotemporal neurofi bromas (plexiform neurofi bromas) , 360 , 364 low-grade pilocytic astrocytomas , 360 Örge, F.H. , 135–138 , 141–145 management and treatment , 412 Osteoporosis , 354 neurocutaneous disorder , 407 OTS . See Ocular trauma scores (OTS) neuroimaging , 363 NF1 , 407 ophthalmic screening , 411–412 P ophthalmologic progression , 363 Paley, G.L. , 418–424 radiographic progression , 363 Panuveitis syndromes , 230 screening and monitoring , 360 , 364 Papilledema , 274 SD-OCT , 360 diagnostic requirements , 418 symptomatic , 360 dilated fundus examination , 418 VEPs , 360 Papillorenal syndrome , 399 visual Outcomes , 412–413 Para-arteriolar retinal pigment epithelium (PPRPE) , 345 Optic pit , 399–401 Parental counseling , 189 814 Index

Parinaud oculoglandular syndrome , 239 children , 109 Park, K.A. , 402 HSV epithelial keratitis , 111 Parks, M.M. , 95 , 480 , 500 , 750 HSV immune stromal keratitis , 111 Parrozzani, R. , 360 ophthalmic examination , 109 Pars planitis rosacea blepharoconjunctivitis , 111 active infl ammatory cells , 226 tree branch injury , 110 aphakia , 226 Pediatric Eye Disease Investigator Group , 652 biomicroscopic examination , 224 Pediatric Eye Disease Investigator Group (PEDIG) , 97 chronic cyclitis and peripheral uveitis , 224 Pediatric glaucoma , 439 , 442 , 454 cystoid macular edema , 226 Pediatric Intensive Care Unit (PICU) , 316 fl uorescein angiography , 226 Pediatric masquerade uveitis . See Masquerade syndrome inactive and old cells , 226 Pediatric ocular trauma lensectomy , 226 ancillary tests , 169 periocular steroid injections , 226 antibiotic prophylaxis , 170 retinal vasculitis and granulomatous infl ammation , 224 conjunctival peritomy , 170 snowbanking and collagen band formation , 225 materials , 169 “step ladder” treatment approach , 226 medication concentrations , 170 Patel, C.K. , 513 , 514 , 516 , 517 , 521 open globe injury , 167, 168 Pattern reversal VEPs (pVEPs) , 411 OTS , 167 , 168 Pearson syndrome (PS) , 334 post-operative care , 170 Pediatric cataract surgery , 188 , 189 prognostic information , 167 Pediatric cataracts steak knife injury , 170, 171 additional tests , 184 , 185 Pediatric orbital fl oor fractures classifi cation , 185 , 186 clinical synopsis , 677–679 examination , 184 long-term follow up , 676–677 presentation , 183 , 184 surgical management , 677 Pediatric contact lens , 60–64 , 66 , 67 Pediatric patients , 8–15 aphakia , 69 accommodative convergence/accommodation (AC/A) ratio , 20 , 21 aphakia treatment , 59 amblyogenic condition , 4 aphakic , 69 double Maddox rod test , 20 binocular vision and stereopsis , 59 examination process , 3 cataract surgery , 59 gradient method , 20–21 component , 68 heterophoria method , 20 consultation motor fusion testing , 18–20 aphakia , 60 nystagmus , 22–23 corneal health , 60 nystagmus/strabismus , 4 fi tting process , 60 , 61 pediatric eye conditions , 3 IOL formula , 61 Prince Rule , 21 parameters , 61 prism neutralization , 18 traumatic cataract , 60 ptosis , 22 cornea without the lens , 68 retinoscopy , 22 fi tting process sensory testing , 18 determination, base curve , 62–63 strabismus , 8–15 diameter , 66 , 67 strabismus measurement and detection (see Strabismus ) Refraction determination , 63 , 64 , 66 vestibular system , 4 fl uorescein pattern , 68 visual acuity , 4–8 glasses , 59 visual attention , 4 GP lens, corneal scar , 70 Pediatric pseudotumor cerebri syndrome (PTCS) , 418–420 GP lenses , 68 CSF opening pressure , 424 insertion and removal process , 68 diagnosis material , 67–68 fl owchart , 418 , 419 microbial keratitis , 68 normal brain parenchyma , 418 off-eye evaluation of the contact lens , 68 papilledema , 418 on-eye evaluation of the fi t with white light , 68 venous imaging , 418 power , 68 ICP, unclear etiology , 418 replacement , 68 primary , 418–421 selection secondary , 418 , 423 GP lens , 62 treatment materials/designs , 61 acetazolamide vs . placebo , 418 RGP , 62 lower ICP and weight loss , 419 Silsoft® lens , 61 OCT measurements , 420 training, caregivers , 68 patient’s specifi c clinical presentation , 419 Pediatric corneal ulcers side effects , 419 amblyopia , 116 young, prepubertal population , 422 and microbial keratitis , 116 Pediatric refractive surgery , 74–76 anterior stromal infi ltrate , 110 case studies , 73 , 74 astigmatism , 109 corneal changes , 76 Index 815

indications , 74 Kivlin–Krause syndrome , 135 LASIK and PRK procedures , 75 Krause–Kivlin syndrome , 136 post-operative correction , 77 lens vesicle , 135 refractive error, ranges , 75 management , 137 surgical candidates ocular abnormalities , 136 amblyopia , 74 ocular malformations , 135 craniofacial/musculoskeletal disorders , 75 ophthalmology evaluation fi ndings , 139 treatment options penetrating keratoplasty (PK) , 136 anisometropia , 75 Peters plus syndrome , 136 hyperopic patients , 76 prenatal alcohol exposure , 135 PIOL , 75 , 76 sclerocornea , 136 Periocular infections ultrasound biomicroscopy , 139 , 140 CBC testing , 668 Pfaffenbach, D. , 550 classifi cation , 668 Pfeiffer syndrome , 712 clinical decision-making process , 668 Phakic IOL (PIOL) implantation , 75 description , 667 Phakomatoses , 359 intracranial involvement , 668 encephalofacial angiomatosis (Sturge-Weber syndrome) , 372 masquerade-type conditions , 668 familial adenomatous polyposis (Gardner Syndrome) , 372 MRSA , 669 gene, protein and diagnostic criteria , 361–362 oral vs . intravenous antibiotics , 668 genetic and pathophysiologic criteria , 359 orbits imaging , 668 NF1 (see Neurofi bromatosis type I (NF1) ) subperiosteal abscess , 669 NF2 (see Neurofi bromatosis type 2 (NF2) ) subperiosteal elevation along lamina papyracea , 670 , 671 retinal abnormalities , 366 subtle post-septal infl ammatory changes without abscess , 672 , 673 retinal angiomatosis (von Hippel-Lindau) , 366–370 Peripapillary staphyloma , 400–402 TSC , 370–372 Perry, J.D. , 561 , 675–679 Pharyngoconjunctival fever , 105 Persistent fetal vasculature (PFV) PHPV . See Persistent hyperplastic primary vitreous (PHPV) amblyopia therapy , 196 Pichi, F. , 213–217 , 219 , 220 , 251–256 Bergmeister papilla , 192 PICU . See Pediatric Intensive Care Unit (PICU) cataract , 197 Pierce, J.B. , 313–318 clinical genetics , 194 Pigmented ocular fundus lesions (POFLs) , 372–374 Coats’ disease , 194 PIOL . See Phakic IOL (PIOL) implantation coloboma , 192 , 193 Plaque radiation therapy (Brachytherapy) , 390 , 391 corneal opacifi cation , 193 Ple-plakon, P.A. , 109–116 deformations and malformations , 191 Plexiform neurofi bromas , 360 , 364 diagnosis , 195 Pollard, Z.F. , 552 embryology , 193–194 Polyarteritis nodosa (PAN) , 230 etiology , 191 Portable fundus cameras , 263 , 264 , 267 , 268 FEVR , 195 Posterior segment heritable systemic diseases , 193 abusive head trauma , 309 intraocular cautery , 196 amphotericin B , 308 intraocular scissors , 196 anterior segment exam , 310 lensectomy and limbal approach , 196 blunt trauma , 307 Mittendorf dot , 192 chalcosis , 308 molecular genetics , 194 cornea and limbus , 307 Norrie disease , 195 dense vitreous hemorrhage , 309 ocular toxocariasis , 195 diffuse intracerebral hemorrhage , 311 patients , 191 dilated fundus exam , 310 PHPV , 192 endophthalmitis , 308 posterior stalks , 193 fl uorescein angiography , 311 pupillary membrane , 191 , 192 fundus photographs , 310 , 311 retinal detachment , 195 intraocular wire , 310 retinoblastoma , 194 IOFB , 308 ROP , 195 laser indirect ophthalmoscopy , 311 surgery , 196 , 197 metallosis bulbi , 308 treatment , 195–196 monocular blindness , 307 tripartite classifi cation system , 192 non-accidental trauma , 309 Persistent hyperplastic primary vitreous (PHPV) , 191 , 332 OTS , 307 Peters anomaly pediatric ocular trauma score , 307 , 308 beta 1,3-galactosyltransferase-like (B3GALTL ) , 135 penetrating and perforating injuries , 308 bilateral corneal leukomas , 139 premacular hemorrhage , 309 corneal opacifi cation , 136 preretinal and nerve fi ber layer hemorrhage , 309 corneal opacity , 137–138 RAPD , 307 diagnosis , 136 retinal heme , 311 glaucoma , 136 , 138 seizures , 311 heterogeneous chromosomal abnormalities , 135 ultrasound biomicroscopy , 309 homeobox genes , 135 vitreous cavity , 308 816 Index

Posterior uveitis goniotomy , 444 anterior uveitis , 224 management , 444 basic laboratory investigation , 224 optic nerve examination , 444 cataract, glaucoma and band keratopathy , 224 primary corneal disease , 444 CME and ERM , 224 Tonopen ® , 443 , 444 diagnosis , 224 cycloplegic refraction , 441 eye and fundus , 223 diagnosis , 440 IMT , 223 dilated fundus examination , 441 initial evaluation , 224 genetic basis , 441 , 442 macular edema/dense vitreous haze , 224 glaucoma medical management , 223 anterior segment examination , 446 , 447 oral corticosteroids , 223 automated visual fi eld (AVF) , 446 sarcoidosis/polyarteritis nodosa , 224 band keratopathy and posterior capsular opacifi cation , 446 Postnatal growth in ROP studies (G-ROP) , 301 bleb-related endophthalmitis , 446 Post-traumatic endophthalmitis , 170 B-scan ultrasound image , 447 PPRPE . See Para-arteriolar retinal pigment epithelium (PPRPE) C/D ratio , 447 Prematurity , 46 , 47 central corneal thickness (CCT) , 446 myopia conjunctiva , 446 retionpathy , 46 , 47 cycloablation , 447 , 448 Prendiville, P. , 569 cycloplegic retinoscopy , 446 Preseptal cellulitis defi nitive plan , 446 eyelid trauma , 667 diode cyclophotocoagulation , 447 oral vs . intravenous antibiotics , 668 endophthalmitis , 447 pediatric population , 667 (see also Periocular infections ) goldmann applanation tonometry (GAT) , 446 Presumed ocular histoplasmosis syndrome (POHS) , 244 , 245 gonioscopy , 446 Primary congenital glaucoma (PCG) , 443–448 inferonasal quadrant , 447 anterior segment , 441 light perception (LP) , 446 automated visual fi eld testing , 441 macula , 446 axial length , 441 management , 446–448 buphthalmos and corneal edema optic nerve examination , 446 angle surgery , 445 optical coherence tomography (OCT) , 446 anterior segment examination , 444 surgical history , 446 anterior segment photograph , 445 Tonopen ® , 446 axial length , 444 trabecular meshwork (TM) , 446 blepharospasm, epiphora, and photophobia , 445 ultrasound , 447 central corneal thickness , 444 visual acuity , 446 , 447 cycloplegic refraction , 445 glaucomas , 440 gonioscopy , 445 gonioscopy , 441 goniotomy , 445 intraocular pressure (IOP) , 440 management , 445 latanoprost and brimonidine surgical treatment , 445 glasses , 445 Tonopen® , 444 , 445 gonioscopy , 445 trabeculotomy , 445 management , 445 visual acuity , 445 trabeculectomy , 446 within normal limits (WNL) , 444 visual acuity , 445 cloudy eyes medical treatment , 442 angle surgery , 443 OCT , 441 anterior segment examination , 443 surgical treatment , 441–442 central corneal thickness (CCT) , 443 trabecular meshwork , 441 cup-to-disk (C/D) ratio , 443 Primary pediatric optic nerve sheath meningioma (PPONSM) , 689 cycloplegic retinoscopy , 443 Prism dioptre (PD) , 492 intraocular pressure (IOP) , 443 Pritchard, C. , 3–15 , 17–23 management plan , 443 Pritchard, C.H. , 500 metabolic acidosis and tachypnea , 443 PRK , 75 myopic refl ex , 443 Proptosis, children , 682–699 retinoscopy , 443 congenital orbital cystic lesions visual acuity , 443 dermoid cysts , 684 , 685 wince to light (WTL) , 443 microphthalmia with cyst , 682–683 corneal haze diagnostic testing and imaging , 682 anterior segment examination , 443 , 444 differential diagnosis , 682 , 683 axial lengths , 444 hematologic tumors (see Hematologic tumors ) C/D ratio , 444 infl ammatory lesions central cornea thickness (CCT) , 444 nonspecifi c , 685–686 diagnosis , 444 ruptured dermoid cyst , 687–688 examination under anesthesia (EUA) , 443 thyroid eye disease , 686–687 gonioscopy , 444 medical history , 681 Index 817

mesenchymal tumors Retinal and optic nerve head hemangioblastomas , 369–370 leiomyoma , 698 Retinal angiomatosis , 366–370 orbital rhabdomyosarcoma , 695–698 Retinal detachment , 195 , 255 , 256 metastatic tumors Retinal dystrophies , 748 orbital retinoblastoma , 699 achromatopsia , 339–341 secondary cystic lesions , 699 algorithm , 337 , 338 neural tumors ancillary tests , 339 ONG , 688 BSS , 342–344 optic nerve sheath , 689 children and infants , 337 orbital schwannomas , 689 cone disorders , 339 orbit examination , 681–682 inherited conditions , 337 vascular lesions isolated ophthalmic disease , 337 capillary hemangioma , 689–691 LCA , 345 malformations , 691–694 medical and vision history , 337, 339 PS . See Pearson syndrome (PS) medical/surgical history and ROS , 339 Pseudo-Brown syndrome , 632 Retinal hemorrhages Pseudopapilledema , 402 , 403 abusive head trauma , 315 Ptosis , 526–528 acceleration-deceleration injuries , 314 astigmatic changes , 22 brain injury , 317 marginal refl ex distances and levator , 22 epidural hematoma , 315 skeletal and muscular changes , 22 hemorrhagic retinopathy , 316 Pushker, N. , 669 optic nerve injury/retinal detachment , 318 optimal visual function , 317 traumatic brain injury , 314 Q Retinal imaging, pediatric patients , 262–268 Qian, Y. , 652 considerations examination setting , 262 medicolegal risk , 262 R patient age , 262 Radiation therapy physical or intellectual disability , 262 retinoblastoma , 391 diagnosis , 261–262 Ramaesh, K. , 130 imaging modalities , 263–268 Random dot stereoacuity test , 34 FA , 263–265 RAPD . See Relative afferent pupillary defect (RAPD) FAF , 265 RB1 gene , 380 , 381 , 383 fundus camera , 263 RBCs . See Red blood cells (RBCs) ICGA , 265 Red blood cells (RBCs) , 452 infrared imaging , 265 Red eye fl ow chart , 107 , 108 SDOCT , 265–267 Red -glass test ultrasonography , 267–268 diplopia , 31 monitoring, progression and prognosis , 262 exotropia , 31 utility , 268–269 Reem, R.E. , 667–673 , 719 , 720 , 722 Retinal nerve fi ber layer (RNFL) , 273 Reese, A. , 384 Retinal toxicity , 321 , 322 Refractive amblyopia , 52 , 53 , 82 Retinal vasculitis , 239 , 240 Refractive error , 46 , 52 , 57 , 662 Retinitis pigmentosa (RP) , 295 astigmatism Retinoblastoma , 194 , 252 , 253 , 379–385 , 387–391 guidelines , 52 classifi cation , 384 , 387 Marfan syndrome , 57 clinical features , 381 myopia (see Myopia ) description , 379 Regular astigmatism diagnostic imaging , 382–383 , 386 ATR , 53 differential diagnosis , 381–382 high WTR , 53 genetics mild degree of oblique , 53 bilateral and multifocal tumors , 380 shape, cornea, and lens , 51 counseling , 380 subtypes , 51 development , 379 with the rule (WTR) , 53 germline mutation , 380 Relative afferent pupillary defect (RAPD) , 307 patients diagnosed , 380 Remote near point of convergence (NPC) , 19 pinealoblastoma , 380 Repka, M.X. , 500 RB1 gene , 380 Residual amblyopia , 92 tumor suppressor gene , 379 Retcam 3® , 264 management RetCam® , 303 chemotherapy , 388–390 Retina , 308 , 310 , 311 cryotherapy , 390 Retinal abnormalities enucleation , 387–388 CHRRPE , 366 laser therapy , 390 neuro-ophthalmologic fi ndings , 366 patient-related factors/physician-related factors , 385 vitreoretinal interface abnormalities , 366 , 367 plaque radiation therapy (Brachytherapy) , 390 , 391 818 Index

Retinoblastoma (cont .) Sakurai-Lisch nodules , 360 , 363 radiation therapy , 391 Sanger sequencing , 336 treatment selection , 385 Sanger, F. , 330 non-ocular tumors , 383 Sarcoidosis , 226–227 stepwise evaluation Saunders, R.A. , 552 diffuse inﬁ ltrating type , 381 , 384 SBS . See Shaken baby syndrome (SBS) endophytic growing beneath , 381 , 383 Schmitt, M.A. , 337 , 339 , 341 , 342 , 344 , 346 , 349–351 exophytic growing beneath , 381 , 383 Schwartz, T.L. , 725 , 726 , 731–733 ophthalmic ultrasonography and examination , 381 , 382 Scleral perforation , 642–643 ophthalmoscopy , 381 Scobee, R.G. , 500 orbital cellulitis , 381 , 385 Scott, A.B. , 567 vitreous seeding , 381 Scott, J.A. , 759 Retinocytoma , 381 SD-OCT . See Spectral domain optical coherence tomography Retinoma , 381 (SD-OCT) Retinopathy of prematurity (ROP) , 195 Sears, J.E. , 307–311 abnormal proliferative process , 300 Sears, N.C. , 307–311 BEAT-ROP , 303 Sejpal, K. , 165 ETROP , 303 Şekeroğlu, H.T. , 593–596 , 598–602 hypoxia , 300 Sener, E.C. , 593–596 , 598–602 ICROP , 300 Sensorial adaptations IGF-1 and VEGF , 300 binocular vision , 25–27 laser photocoagulation , 304 neurodevelopmental changes , 25 neovascularization , 304 random dot stereoacuity test , 34 pathogenesis , 300 stereopsis , 33 retinal vessels , 300 strabismus , 28–29 right eye , 303 , 304 Titmus stereo test , 34 screening , 301–302 Septo-optic dysplasia , 396 stages , 300 , 301 Shaken baby syndrome (SBS) , 309 subgroups , 301 Sheldon, C.A. , 418–424 venous dilation and arteriolar tortuosity , 301 Sherrington’s laws , 8–9 zones , 300 , 301 Shieh, C. , 155–165 Retinoscopy Shields, J.A. , 236 cycloplegia , 761 Shorr, N. , 563 examiner positioning and technique , 762 , 763 Sickle cell disease , 150 , 151 loose lenses vs . phoropter , 761 Silicone expanders , 630 nonverbal/preverbal patients , 761 Silsoft® lens , 61 , 62 refraction , 761 Simultaneous prism and cover test (SPCT) sleeve position , 761 , 762 esotropia , 10 Rhabdomyosarcoma occluder , 10 CT and MR imaging features , 696 Singh, A.D. , 379–391 histological types of , 696 Single nucleotide polymorphism (SNP) , 336 orbital , 695–697 Sinusitis pathological features , 696 orbital cellulitis , 668 signs and symptoms , 696 preseptal cellulitis , 667 subacute painless proptosis , 681 Sisk , R.A. , 261–265 , 268 Richards, B.W. , 506 SITA fast 24-2 protocol , 431 Rigid gas permeable , 62 Sixth nerve palsy Risk models for ROP version 2 (RM-ROP2) , 302 amblyopia , 510 Robitaille, J. , 353–357 amblyopia and suppression , 508 Rod cone dystrophy (retinitis pigmentosa) , 283 anterior segment ischemia , 509 Rod monochromatism , 339–341 central nervous system , 506 Rosacea keratoconjunctivitis CN VI abducens nerve , 506 diagnosis , 115 cranial nerve , 506 doxycycline/erythromycin , 116 diplopia , 509 pathogenesis , 115 distribution and etiology , 505 risk factors , 115 esotropia , 506 treatment , 115–116 Hummelsheim procedure , 508 R P . See Retinitis pigmentosa (RP) interval history (2 weeks) , 509 , 510 Rubella , 244 interval history (4 weeks) , 510 Rubin, P. , 668 interval history (4-8 weeks) , 510 Rungger-Brandle, E. , 105 intracranial pathology , 508 Rutar, T. , 669 intraoperative botulinum injection , 509 Jensen procedure , 508 lumbar puncture , 510 S management , 508 , 509 Saccadic oscillations , 747 , 752 medial rectus recession and lateral rectus resection , 508 Saethre-Chotzen syndrome , 710 , 711 motility , 506 Index 819

muscle transposition , 508 diplopia , 30–33 neoplasm , 506 DS , 736–737 neuroimaging , 510 ductions test , 17 ophthalmoscopy , 506 efferent defects , 491 paralytic strabismus , 505 fi xation (left/right eye) , 12 Skew deviation , 610 Gaze measurements , 12 Skov, C.M. , 569 haploscopic devices , 14 Smith, A.E. , 103–107 haploscopic tests , 33 Smooth pursuit asymmetry , 484 Herring’s and Sherrington’s Laws , 8–9 S N P . See Single nucleotide polymorphism (SNP) Hirschberg method , 14 Spasmus nutans Krimsky method , 14 amblyopia and strabismus , 751 latent deviations , 10–11 in infants , 751 Maddox rod test , 12–13 neuroimaging , 751 manifest deviation , 9–10 nystagmus, head nodding and torticollis , 751 manifest/latent , 8 retinal dystrophies , 751 ocular rotations , 15–18 suprasellar tumors , 751 partial correction , 38 SPCT . See Simultaneous prism and cover test (SPCT) red glass test , 31 Spectral domain OCT (SD-OCT) , 271 sensory adaptation , 492 Spectral domain optical coherence tomography (SD-OCT) , 217 , 218 , suppression , 28–33 262 , 265–267 , 360 version testing , 15 , 17 Spierer, O. , 641–646 W4D , 31 Sprunger, D.T. , 605 , 606 , 608 , 610 Strabismus age-based screening and referral criteria , 84 Stahl, E.D. , 73–77 Strabismus reoperation , 616–619 Stair-case approach , 95 cyclovertical deviation , 614 Stargardt disease , 277–278 ductions and versions , 614 adenosine triphosphate (ATP) , 351 early childhood , 613 ancillary tests , 350 extraocular muscles , 613 autofl uorescence (AF) , 350 eye muscle/periocular surgery/trauma , 613 , 614 color fundus photo , 349 eye/muscles , 613 FAF , 349 fat adherence syndrome , 620 fl uorescein angiography , 349 , 350 forced duction testing , 614 fundus autofl uorescence imaging , 349 forced generation testing , 614–616 fundus fl avimaculatus , 350 inferior rectus muscle , 620 gene therapy trials , 351 medical records , 613 genetic types , 351 motor function , 614 multifocal ERG , 351 nerve palsy , 620 photoreceptor layer , 350 ocular surgery , 613 red blood cell lipids , 351 operative fi ndings , 620 retinal dystrophy , 349 preoperative and intraoperative assessment , 621 SD-OCT , 349 , 350 restrictive or paralytic strabismus , 614 visual prognosis , 351 scleral buckle surgery , 620 vitamin A supplementation , 351 slipped and lost muscles , 619 Stereo tests , 18 surgical approach Steroids for Corneal Ulcers Trial (SCUT) , 113 adjustable sutures , 618 Stickler Syndrome , 47–48 anterior segment blood supply , 617 Stilling–Türk–Duane’s syndrome anterior/ posterior direction , 618 horizontal gaze palsy and progressive scoliosis , 596 blebs , 617 Möbius syndrome , 595 conjunctival incision , 617 synergistic horizontal divergence , 595–596 eye surgery , 617 Stimulus deprivation amblyopia , 96 fornix incision , 617 Strabismic amblyopia , 82 healing process , 619 Strabismic or Combined Strabismic/Refractive Amblyopia , 86 limbal conjunctival approach , 617 Strabismus , 550 , 660–662 limbal incision approaches , 617 4 Δ base-out prism test , 32 limbal incisions , 618 afferent defects , 490–491 optimal immediate postoperative alignment , 619 afterimage test , 32–33 orbital anatomy and physical principles , 617 amblyopia , 28 orthophoria , 619 and amblyopia , 37 , 38 physical exam and patient goals , 617 angle kappa , 13–14 pseudotendon and actual tendon , 618 ARC , 29 , 30 randomized control trials , 618 Bagolini striated lenses , 32 scar tissue , 618 consistent glasses wear , 37 scar tissue and Tenon’s capsule , 618 corneal light refl ex assessment , 13 sclera , 618 cover testing , 9 scleral buckles/glaucoma drainage devices , 618 development , 39 tendon or pink muscle fi bers , 618 820 Index

Strabismus reoperation (cont .) Thompson, H.S. , 759 Tenon’s capsule , 618 Thyroid eye disease (TED) , 564 , 566 , 686–687 two-plane fornix incision , 618 active and infl ammatory phase , 560 two-plane incision , 617 adjustable suture technique , 569 Wescott scissors , 618 anesthesia , 568 surgical planning , 620 bilateral inferior rectus surgery , 571–573 binocular vision , 616 botulinum toxin , 567 consecutive exotropia , 617 classifi cation , 563 contralateral muscles , 616 contralateral surgery , 571 goals and potential adverse outcomes , 616 corticosteroids and immunosuppressants , 560 limbus , 616 CT , 564 limitations , 616 duction-based surgery , 569–570 loss of elasticity , 617 EOM fi brosis and optic neuropathy , 560 medial rectus muscles , 616 etiology, thyroid orbitopathy , 560 muscle placement , 617 eye muscle surgery , 571 patient’s expectations , 616 four-muscle surgery , 573 preoperative evaluation , 616 goals , 560 re-recessions , 617 grading , 562 specifi c professional or leisure activities , 616 Graves’ disease , 559 , 564 visual acuity , 613 hyperthyroidism , 559 Strabismus surgery imaging , 563 anesthesia and surgical techniques , 641 IRMT , 570–571 anterior segment ischemia , 645–646 left hypotropia , 578 bradycardia , 642 lubricants , 560 exposed sutures , 646 management , 568 eyelid position changes , 646 oblique muscle surgery , 573 infection , 644 occlusion , 567 infl ammation , 644–645 ophthalmic examination , 561–562 intraoperative complications , 642–643 ophthalmic signs and symptoms , 561 lost muscle , 643 orbital decompression , 560 , 563–564 malignant hyperthermia , 642 pitfalls and complications , 575–577 oculocardiac refl ex , 642 planning strabismus surgery , 568 preoperative planning , 641–642 prisms , 567 refractive changes , 646 QOL , 577 sarcoplasmic reticulum membrane , 642 quantitating ductions , 562 scleral perforation , 642–643 radiation therapy , 560–561 slipped muscle and stretched scar , 643–644 reoperations , 573–575 slipped muscle/orbital cellulitis , 641 resection , 575 Straight, S.M. , 583 , 584 , 586 , 588 , 589 , 591 right hypotropia , 565 Straka, D. , 705–708 , 710 , 712–716 stability , 575 Stromal keratitis , 122–124 and strabismus Sturge–Weber Syndrome , 372 cardinal gazes , 566 Subperiosteal abscess , 668–670 double Maddox rod testing , 566 Sultan, G. , 203 ductions and versions , 564 Suprasellar tumors , 751 exotropia , 566 Swept-source OCT (SS-OCT) , 271 Goldmann perimeter, binocular vision , 566 Sympathetic ophthalmia (SO) , 227–228 intraocular pressure measurements , 566 Synkinetic syndromes , 661 photographs , 566 Syphilis prism and cover testing , 566 acquired ocular syphilis , 238 surgery , 568–569 congenital , 238 , 239 surgical indications , 568 diagnosis , 238 testing , 562–563 ocular , 239 upgaze , 566 , 568 Szperka, C. , 418–424 Thyroid orbitopathy , 560 , 561 Thyroid-stimulating hormone receptor (TSH-R) , 560 Thyroid-stimulating immunoglobulin (TSI) , 562 T Tilted disc syndrome , 401–402 Taich, A. , 759 Time domain-OCT (TD-OCT) , 271 Telemedicine Approaches to Evaluating Acute Phase ROP study Titmus stereo test , 34 , 759 (e-ROP) , 302 Todman, M.S. , 669 Tendency Oriented Perimetry (TOP) protocol , 431 Toldo, I. , 759 Teratomas , 684 , 685 T O P . See Tendency Oriented Perimetry (TOP) protocol The Intergroup Rhabdomyosarcoma Study (IRSG) , 695 Topical steroids , 216 Thiagalingam, S. , 412 Torticollis , 739 Third nerve palsy , 525 Toxocariasis Thomas, S.M. , 570 defi nition , 236 Index 821

ocular , 236 , 237 Genetic testing , 354 Toxoplasmosis hemorrhages , 356 acquired , 235 KIF11-related disease , 356 congenital , 234 management approach , 356 ocular , 234 ophthalmoscopy , 353 Trabeculectomy , 470 unilateral avascular retina , 354 Trabeculotomy , 441 , 445 , 454 Vascular endothelial growth factor (VEGF) , 300 Traboulsi syndrome , 205 Vascular lesions Traboulsi, E.I. , 191 , 193–197 , 199 , 201–207 , 329–337 , 339 , 341 , 342 , capillary hemangioma , 689–691 344 , 346 , 349–351 , 359–374 , 395–405 , 547 , 548 , 550–554 , malformations , 691–694 559–564 , 566–571 , 573 , 575 , 577 , 652 , 757–760 Velez, F.G. , 552 Trapdoor fractures Venipuncture , 264 ischemia, extraocular muscle , 676 V E P . See Visual evoked potential (VEP) signal pediatric population , 676 Vernal keratoconjunctivitis (VKC) Treacher-Collins syndrome , 712 calcineurin inhibitors , 106 Trisomy 21 , 736 corneal ulcers , 106 Trivedi, R.H. , 61 , 183–189 Horner-Trantas dots , 106 Trochlear nerve palsy , 513 neovascularization and scarring , 106 Tsang, S.H. , 291 , 293 , 295 ocular surface allergy , 106 Tuberculosis (TB) olopatadine , 106 intraocular , 240 papilla , 106 ocular , 240 steroids , 106 ocular involvement , 240 symptoms , 106 tuberculous choroidal granulomas , 240 tacrolimus (Protopic® ) and cyclosporine (Restasis) , 106 tuberculous uveitis , 240 Vertical nystagmus in infancy Tuberous sclerosis complex (TSC) Arnold–Chiari malformations , 752 adenoma sebaceum , 370 congenital downbeating nystagmus , 751 autosomal dominant multi-systemic disorder , 370 eye positions , 751 , 752 central nervous system , 370 ophthalmologic examination , 751 diagnostic criteria , 370 Vicente, G.V. , 761–763 , 765 , 766 hamartomas , 371 Vigabatrin (Sabril®) neuroimaging , 370 age-based vigabatrin retinal toxicity monitoring prevalence ranges , 370 guidelines , 322 retinal and optic nerve head astrocytic hamartomas , 370 benefi ts of screening , 323 visceral manifestations , 370 drug , 321 Tubulointerstitial nephritis and uveitis syndrome (TINU) , 228 electrophysiological testing , 322 Tychsen, L. , 480 γ-aminobutyric acid transaminase (GABA-T) , 321 Goldmann visual fi elds , 323 internal limiting membrane (ILM) and atrophy , 322 U irreversible visual fi eld constriction , 321 Ultrasonography , 267 ophthalmologic assessment , 322 Ultrasound biomicroscopy (UBM) , 253 peripheral retinal function , 321 Unilateral congenital cataract, left eye photopic 30-Hz fl icker amplitudes , 323 aphakic glaucoma , 464 photopic ERG 30-Hz fl icker response and Goldmann visual fi eld , glaucoma , 461 324 , 325 history , 460 , 464 retinal nerve fi ber layer , 321 , 322 interval history (1 month) , 461 standard of care , 322 interval history (1 week) , 461 visual dysfunction and dose , 321 interval history (3 months) , 464 visual fi eld constriction , 321 interval history (5 months) , 461 visual fi eld defects , 321 management , 460 , 464 visual fi eld testing , 322 Utz, V.M. , 81–97 , 175–181 , 359–374 , 535–537 , 539–543 Viral conjunctivitis Uveitis , 216 , 251 . See also Infectious uveitis EKC , 105 pharyngoconjunctival fever , 105 prodrome , 104 V red burning right eye , 104 Vajpayee, R. , 158 serotypes , 104 Van Mierlo, C. , 411 visual acuity , 104 Varicella zoster virus (VZV) , 119 , 125–126 , 241 Viral keratitis Vascular disorder corneal scaring , 115 avascular retina , 354 diagnosis , 114 bilateral congenital retinal , 356 pathogenesis , 114 bilateral vitreous bands , 356 risk factors , 114 diagnosis , 354–355 treatment , 115 eye disease/blindness , 353 VISA infl ammatory score , 562 822 Index

Vision impairment , 731–733 Von Hippel-Lindau (VHL) albinism and optic nerve atrophy , 726 3p25-26 , 366 binocular , 731 case study , 368 clinical low vision evaluations , 725 clinical manifestations , 366 contrast sensitivity function , 731 retinal and optic nerve head hemangioblastomas , 369–370 craniopharyngioma , 728 surveillance guidelines , 368 devices and magnifi cation , 731 V Z V . See Varicella zoster virus (VZV) education services assistive technology , 732 braille , 732 W children and adolescents , 732–733 Waldman, A.T. , 433 classroom setting , 732 Wall, P.B. , 395–405 learning media assessment , 732 Wei, L.A. , 676 medical and educational eligibility , 731 Weight, Insulin-like growth factor I, Neonatal ROP algorithm orientation and mobility (O&M) , 732 (WINROP® ) , 301 print, braille/dual media , 732 Weill-Marchesani syndrome , 204 , 205 electronic and computer magnifi cation systems , 725–726 Weill-Marchesani syndrome (WMS) , 199 electronic magnifi cation , 728 Weiss, A.H. , 412 learning , 725 WES . See Whole-exome sequencing (WES) literacy , 726 West, C.E. , 500 nystagmus and esotropia , 728 WGA . See World Glaucoma Association (WGA) oculocutaneous albinism , 728 Whitaker, L. , 720 optical devices , 725 Whole-exome sequencing (WES) , 330 , 336 visual function assessment tools , 725 , 726 Wierda, S.B. , 150–152 Vision loss Wiesel, T.N. , 82 clinical eye examination , 419 Williams, W.T. , 104 optic nerve compression , 421 Wilson, M.E. , 61 , 183–189 treatment, PTCS , 419 Winkler, K.P. , 525–527 , 531 Vision rehabilitation , 732 World Glaucoma Association (WGA) , 439 , 457 Visual acuity , 5–8 , 86 , 87 World Health Organization (WHO) , 216 qualitative methods Worth 4- dot test amblyopia , 6 monofi xation syndrome , 31 base-down prism , 6 , 7 Worth 4-dot test , 18 , 480 binocular conditions , 5 Wright, K.W. , 500 fi xation preference , 6 Wyburn-Mason syndrome , 692 monocular testing , 5 nystagmus , 8 optotype monocular , 8 X poor vision/visual attention , 7 Xanthogranuloma , 695 preliterate vision , 7 quantitative methods logMAR , 5 Y Teller acuity card , 5 Yang, M.B. , 300–304 Visual evoked potential (VEP) signal , 431 Yousuf, S.J. , 507 Visual evoked potentials (VEPs) , 360 , 411 Y-pattern exotropia , 624 , 626 , 627 Visual rehabilitation , 187 Vitrectomy , 309 , 310 Vitreoretinal interface abnormalities , 366 , 367 Z Vogt , 229 Zamora, B.G. , 261–265 , 268 Vogt–Koyanagi–Harada syndrome (VKH) , 229 Zee, D.S. , 752 Voluntary nystagmus , 753 Zhang-Nunes, S. , 705–708 , 710 , 712–716