Pediatrics

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While the Goldmann applanation tonometer is a very accurate instrument for measuring IOP compared with previous instruments, ophthalmologists now know that central corneal thickness (CCT) is much more variable than was believed when the instrument was developed.

Wavefront preparation time plus the surgical time equals the actual time of the procedure. Different factors associated with each platform add to the preparation time for the procedure.

How much change do we need?

Coming home in the evening, I sometimes feel compelled to share with my daughter and spouse something I learned at work that day. This is always a mistake. Invariably my wisdom is greeted with a quick retort from my teenage daughter: "Dad, stop talking." My darling wife and love of my life is more generous; after expressing interest and asking a few questions, she tells me where I have gone wrong. Sometimes this results in an argument, as it did on this evening.

As a pediatric ophthalmologist, Mark Silverberg, MD, relies on special tactics and tools to make his young patients feel at ease. Dr. Silverberg is pleased to have a new book to share with kids and their families that tells the story of eye surgery from a child's perspective, in simple terms with illustrative photographs.

Chicago-High allergen counts this season combined with increased parental awareness about the potential functional impact of allergic conjunctivitis are leading to an increase in the number of pediatric patients being seen for control of ocular allergy.

Santa Ana, CA-James V. Mazzo can add chairman of the board to his title at Advanced Medical Optics Inc. (AMO), where he is also director, president, and chief executive officer.

Fort Lauderdale, FL-An investigational longacting solution of 1.0% azithromycin (AzaSite, InSite Vision) is safe, well tolerated, and effective for the treatment of bacterial conjunctivitis in pediatric patients and adults, according to the results of pivotal phase III clinical trial involving placebo and active controls.

I have been using endoscopic cyclophotocoagulation (ECP) to treat patients with cataract and medically controlled glaucoma for 5 1/2 years and have found it to be a very useful addition to my armamentarium. The procedure is particularly attractive as an adjunct to small-incision cataract surgery. It takes only about 5 to 10 extra minutes to add ECP to phacoemulsification.

Los Angeles-Joseph L. Demer, MD, PhD, a noted authority on extraocular muscle movement, has been named the first holder of the Leonard Apt Endowed Chair in Pediatric Ophthalmology at the Jules Stein Eye Institute at the University of California, Los Angeles (UCLA).

San Francisco-The American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, and American Academy of Pediatrics released a series of recommendations on which to base effective detection and treatment of retinopathy of prematurity (ROP). The groups discuss improvements in the possible treatment of ROP and the importance of carefully timed retinal exams by an ophthalmologist for at-risk premature infants.

Dallas-Essilor of America Inc. now offers Definityprogressive lenses through its network of laboratories and otherselect labs nationwide. Definity lenses feature Dual Add, apatented technology that maximizes available design space of thelens, minimizing peripheral distortion and providing a smoothertransition between all distances.

Sacramento, CA-Obtaining reimbursement and resources forvision screening seems to be a thankless task with little return.However, there are strategies that can be used to give pediatricvision screening a fair share of the available health-care funds,according to James Bradford Ruben, MD.

Clowning around

When Stephen R. Powell, MD, is spreading cheer throughout the community, his patients usually do not recognize him. Why? Dr. Powell moonlights as a unicycle-riding clown.

Portland, OR?Mass vision screening of school-age children was first recommended in 1983. At that time there was not a large population of children of preschool age, a situation that has changed markedly since then because today many more 3- and 4-year-olds are in a preschool setting. However, there is still no standardization in vision screening.

Madison, WI - Uniform testing and reporting criteria are needed toidentify amblyogenic risk factors in children and prevent thedevelopment of amblyopia. Leslie W. France, CO, described theevidence base for the guidelines to detect amblyogenic riskfactors.

Experience from clinical trials and daily clinical practice indicate that loteprednol etabonate 0.2% (Alrex, Bausch & Lomb) is a valuable therapeutic option for both short- and longer-term management of allergic conjunctivitis, according to ophthalmologists who have studied and used this novel anti-inflammatory corticosteroid agent.

Dorado, Puerto Rico?Patients with allergies should be identified and treated before undergoing ophthalmic surgery in order to improve healing for optimal visual outcomes, explained Francis S. Mah, MD, who spoke during the Current Concepts in Ophthalmology meeting in Dorado, Puerto Rico.

Chicago—Screening to detect preclinical vision loss in children is important and should ideally be done in the offices of pediatricians or family practitioners. In addition, it is now time to add objective testing to pediatric practices, according to Robert W. Arnold, MD, who spoke at the annual meeting of the American Academy of Ophthalmology.

In case you have been so busy with your practice and other obligations that you missed it, two medical miracles (my opinion) have recently been reported. Each is only partially relevant to the practice of ophthalmology, but it seems to me that these are worth awareness.

Portland, OR—The novel formulation of timolol maleate 0.5% ophthalmic solution containing potassium sorbate (Istalol, ISTA Pharmaceuticals) is a good option to consider for adjunctive therapy in patients whose IOP is not adequately controlled by a prostaglandin analogue alone, said John R. Samples, MD.

Chicago—Clinicians should use a systematic approach when confronted with the complaint of double vision. Knowing the possible symptoms and signs associated with diplopia can help with the diagnosis, explained Kimberly Cockerham, MD, FACS, at the neuro-ophthalmology subspecialty day meeting during the American Academy of Ophthalmology annual meeting.

Chicago-"When is a lid laceration not just a lid laceration?" When it is occult penetrating orbito-cranial trauma, explained Roger E. Turbin, MD, assistant professor of ophthalmology and associate director of neuro-ophthalmology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School.

Toulouse, France—With lengthening follow-up, the posterior chamber implantable collamer lens (ICL) (STAAR Surgical) continues to be associated with encouraging results in the management of refractive amblyopia in children who have not had a response to conventional therapy with contact lenses or spectacles, said Laurence C. Lesueur, MD.