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intervention. Three patients had multiple surgical procedures performed. Of the procedures performed, four were sinus irrigation, 12 were sinusotomy and drainage, nine were orbitotomy with drainage of abscess, and one was craniotomy with drainage of abscess. Surgical aspirate specimens yielded a higher positive culture result rate with 9/9 of orbital abscesses and 13/16 of sinus aspirates demonstrating a positive yield. Two of the 27 blood cultures had a positive yield. Staphylococcus species was the most common organism isolated. Methicillin-resistant S. aureus (MRSA) represented 73% of S. aureus isolates. Streptococcus species was the next most common pathogen. Three cultures yielded Haemophilus species with one being positive for H. influenzae. CONCLUSIONS: Organisms responsible for causing pediatric orbital cellulitis are evolving, with Staphylococcus followed by Streptococcus species being the most common pathogens. The occurrence of MRSA in pediatric orbital cellulitis is increasing, and empiric antimicrobial therapy should be directed against these organisms if they are prevalent in the community. Sinus and orbital abscess aspirates yielded the greatest number of positive cultures, though these invasive surgical procedures should be performed only when clinically indicated. Reappraisal of Astigmatism Induced by Periocular Capillary Hemangioma and Treatment with Intralesional Corticosteroid Injection Avery H. Weiss, John P. Kelly Ophthalmology 2008;115:390-397 Design: Retrospective, interocular comparison, interventional case series of thirteen infants with anisometropic astigmatism of at least 1.50 diopters induced by PCH. All infants had one or more intralesional corticosteroid injections between 2 and 10 months of age. Results: In affected eyes, mean astigmatisms were 3.75 D (pretreatment) and 1.25 D (post treatment). Reduction of astigmatism was observed within 1 to 14 months after the injection. Despite reciprocal changes in astigmatism and spherical error, the amount of anisometropia remained constant. Conclusion: Intralesional corticosteroid injections resulted in a 63% reduction in mean amount of astigmatism. The treatment effect was due to restoration of the spherical shape of the cornea. Astigmatism is the immediate indication for treatment of PCH with intralesional corticosteroids. . 88
PLASTICS Conjunctival epithelial changes induced by cilia in patients with epiblepharon or entropion. Kim C, Shin YJ, Kim NJ, Khwarg SI, Hwang JM, Wee WR. Am J Ophthalmol. 2007 Oct;144(4):564-9. Epub 2007 Aug 9. PURPOSE: To evaluate the effect of mechanical trauma induced by cilia on the conjunctival epithelium in patients with epiblepharon or entropion and to evaluate changes in epithelium after surgical correction in patients with entropion. DESIGN: Case-control study. METHODS: One hundred and seven eyes of 61 patients were enrolled in this study and were divided into three groups: the epiblepharon group (n = 59), the entropion group (n = 17), and the age-matched control group for the epiblepharon group (n = 31). Impression cytologic specimens were obtained from nasal and temporal bulbar conjunctiva of the epiblepharon and control groups immediately after the induction of general anesthesia. In the entropion group, these were obtained before and one month after surgical correction. Conjunctival changes were graded using the Tseng method and goblet cell densities were compared. RESULTS: Cytologic scores were significantly higher in the epiblepharon group than in the control group (P < .001), and goblet cell densities of nasal and temporal conjunctiva were significantly lower in the epiblepharon group than in the control group (P = .044 and P = .018, respectively). In the entropion group, postoperative scores were significantly lower than preoperative scores in both conjunctival areas (P = .033 and P = .003, respectively). No statistically significant difference was found between nasal and temporal conjunctiva in the three groups. CONCLUSIONS: The persistent mechanical trauma by cilia in patients with epiblepharon or entropion can induce squamous metaplasia of the conjunctival epithelium. However, these conjunctival changes can be reversed by surgical correction. 89
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What’s New and Important in Pedia
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ROP Retinopathy of Prematurity: the
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same diagnosis in 4 of 34 images (1
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PREMATURITY Perinatal care in the t
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STRABISMUS Causes and outcomes for
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METHODS: The medical records of all
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initial positive response to medica
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deviation as an intermittent exodev
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STRABISMUS SURGERY Unilateral reces
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The effect of topical tetracaine ey
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+/-0.08 and 0.34 +/-0.07 mm, for th
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THYROID Cigarette smoking and thyro
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excluding from the cataract group t
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Long-Term Results of Lensectomy in
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CATARACT SURGERY Pediatric anterior
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Suture-related complications after
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included vitrectomy, capsulotomy, c
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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 and 44: RESULTS: Directly after birth, corn
Page 45 and 46: and photophobia (80%). The children
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
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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: ORBIT Porous orbital implants, wrap
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
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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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