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Pediatric microbial keratitis in Taiwanese children. A Review of Hospital Cases Ching-His Hsiao MD, Ling Yeung MD, David Ma MD PhD, Yeong-Fong Chen MD, Hsin- Chiung Lin MD, Hsin-Yuan Tan MD, Samuel Huang MD, Ken-Kuo Lin MD Arch Ophthalmol 2007;125:603-609 Retrospective review of 81 eyes with microbial keratitis in 78 children aged 16 years or younger. Predisposing factors were contact lens wear (40.7%), trauma (21%), ocular disease (14.8%), and systemic disease (11.1%). Eight of the 33 contact lenses were rigid gas-permeable lenses that were worn overnight for orthokeratology. Forty-seven (58%) of the 81 eyes were culture positive (pseudomonas aeruginosa 44.5% and staphylococcus 19.1%). Twelve (14.8%) of the 81 eyes require surgical intervention. Of the 68 eyes that had a best-corrected visual acuity available at the last follow-up, 33 eyes achieved best-corrected visual acuity of 20/25 or better. Conclusions: Predisposing factors for pediatric infectious keratitis vary with age. In the teenage years, the most predominant risk factor is contact lens wear. Infectious keratitis resultant from overnight orthokeratology lenses should receive particular attention. Parents of children who consider overnight orthokeratology should evaluate the benefit of temporary myopia reduction and the risk of infection. Identification of predisposing factors and microorganisms may be helpful for early recognition and treatment of pediatric microbial keratitis. Development and testing of the quality of life in children with vernal keratoconjunctivitis questionnaire. Sacchetti M, Baiardini I, Lambiase A, Aronni S, Fassio O, Gramiccioni C, Bonini S, Bonini S. Am J Ophthalmol. 2007 Oct;144(4):557-63. Epub 2007 Aug 13 PURPOSE: To develop and validate a questionnaire that measures health-related quality of life (HRQoL) in children with vernal keratoconjunctivitis (VKC). DESIGN: Prospective, observational case series. METHODS: An initial list of 42 items was developed and administered to 30 children with active VKC (six girls and 24 boys; mean age, nine +/- two years). The 30 most significant items were selected and converted into questions on a three-step scale for validation in 41 children with active VKC (eight girls and 33 boys; mean age, 9.5 +/- 2.1 years). Twenty-two children also completed the generic KINDL questionnaire. Clinical signs were evaluated and scored and total sign scores (TSSs) were calculated. Validation was performed by factorial analysis and Pearson correlation. Internal consistency was computed by the Chronbach alpha on the extracted factors. RESULTS: Factorial analysis extracted two factors with good internal consistency: symptoms (12 items; alpha = 0.89) and daily activities (four items; alpha = 0.77). Correlations of Quality of Life in Children with Vernal Keratoconjunctivitis (QUICK) scores to KINDL scores were in the expected direction. Most patients reported itching (93%), burning (90%), redness (90%), the need to use eye drops (90%), tearing (83%), 44
and photophobia (80%). The children's greatest concerns were limitations on going to the pool (71%), playing sports (58%), and meeting friends (58%). QUICK symptom scores were correlated significantly to conjunctival hyperemia (P < .001), secretion (P = .042), chemosis (P = .012), superficial punctate keratopathy (P < .001), and TSS (P = .010). CONCLUSIONS: The QUICK questionnaire is a new, simple instrument to measure HRQoL in children with severe allergic conjunctivitis. This test is effective for the global evaluation of the impact of VKC on children's daily lives. Visual Outcome and Corneal Changes in Children with Chronic Blepharokeratoconjunctivitis Sophie M. Jones, Joel M. Weinstein, Phillippa Cumberland, N. Klein, Ken K. Nischal Ophthalmology 2007;114:2271-2280 Design: Noncomparative, interventional, retrospective case series of 27 children with BKC. Methods: Presenting age, best-corrected visual acuity, refractive error, and any corneal or eyelid pathologic features were recorded. Treatment included modified lid hygiene, topical antibiotics, and steroids. Systemic therapy included oral antibiotics and (from 2003 onward), flaxseed oil. Results: Mean age at presentation was 6.9 years and mean follow-up was 2.3 years. Photophobia was reported in 14 patients (52%), anterior chamber inflammation in 6 (22%). Corneal involvement occurred in 44 eyes (81%), history of recurrent chalazia was seen in 18 patients (67%). Best-corrected visual acuity improved in 70% of the affected eyes and remained unchanged in 30%. Superimposed amblyopia was present and treated in 15 patients (48%). No children had significant side-effects from topical treatment. Conclusions: Visual loss may be significant in the BKC. Delayed treatment may result in decreased final BCVA. Adequate management needs both topical and systemic treatment. Flaxseed oil might be an effective anti-inflammatory alternative to long term antibiotics. Reviewer’s Comments: Close ophthalmologic surveillance is recommended for all children suspected of having blepharitis. A history of recurrent chalazia necessitates the exclusion of eyelid and corneal disease. Most children with BKC require prolonged therapy. 45
Page 1 and 2: What’s New and Important in Pedia
Page 3 and 4: ROP Retinopathy of Prematurity: the
Page 5 and 6: same diagnosis in 4 of 34 images (1
Page 7 and 8: PREMATURITY Perinatal care in the t
Page 9 and 10: STRABISMUS Causes and outcomes for
Page 11 and 12: METHODS: The medical records of all
Page 13 and 14: initial positive response to medica
Page 15 and 16: deviation as an intermittent exodev
Page 17 and 18: STRABISMUS SURGERY Unilateral reces
Page 19 and 20: The effect of topical tetracaine ey
Page 21 and 22: +/-0.08 and 0.34 +/-0.07 mm, for th
Page 23 and 24: THYROID Cigarette smoking and thyro
Page 25 and 26: excluding from the cataract group t
Page 27 and 28: Long-Term Results of Lensectomy in
Page 29 and 30: CATARACT SURGERY Pediatric anterior
Page 31 and 32: Suture-related complications after
Page 33 and 34: included vitrectomy, capsulotomy, c
Page 35 and 36: medication. At the last follow-up,
Page 37 and 38: REFRACTIVE ERROR / REFRACTIVE SURGE
Page 39 and 40: demonstrated a positive effect on t
Page 41 and 42: ANTERIOR SEGMENT Conjunctival Melan
Page 43: RESULTS: Directly after birth, corn
Page 47 and 48: Validity and reliability of the Chi
Page 49 and 50: outcomes achieved at cessation of t
Page 51 and 52: METHODS: One hundred and thirteen c
Page 53 and 54: Verisyse intraocular lens implantat
Page 55 and 56: GENETICS Marfan syndrome: from mole
Page 57 and 58: Visual outcome of a cohort of child
Page 59 and 60: primarily affect the photoreceptors
Page 61 and 62: single morphogenetic anomaly in dev
Page 63 and 64: Three genome-wide association studi
Page 65 and 66: • Cafe-au-lait macules • Freckl
Page 67 and 68: Laryngeal and tracheal anomalies Po
Page 69 and 70: Treatment of retinoblastoma: Curren
Page 71 and 72: Secondary acute myeloid leukemia af
Page 73 and 74: one. Patients treated with radiatio
Page 75 and 76: Neuro-ophthalmological management o
Page 77 and 78: CONCLUSION: Canalicular involvement
Page 79 and 80: peripheral retinal vasculitis. The
Page 81 and 82: This article describes a 7-month-ol
Page 83 and 84: eference eyes. Photopic flash ERGs
Page 85 and 86: RESULTS: In models that adjusted fo
Page 87 and 88: ORBIT Porous orbital implants, wrap
Page 89 and 90: PLASTICS Conjunctival epithelial ch
Page 91 and 92: The authors conclude that lash ptos
Page 93 and 94: .03). SBP and DBP were significantl
Page 95 and 96:
CONGENITAL INFECTION Congenital lym
Page 97 and 98:
PEDIATRICS Visual Manifestations of
Page 99 and 100:
controversial, ranging from one to
Page 101 and 102:
SYSTEMIC Visual function and ocular
Page 103 and 104:
Toxocara infection. Toxocara GWC an
Page 105 and 106:
congenital cataracts. The retina wa
Page 107 and 108:
Childhood blindness: a UK epidemiol
Page 109:
safe and efficient procedure to cor
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