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Purpose: Retinal ischemia/reperfusion (I/R) injury is a common cause of visual impairment and blindness for which there remain limited treatment options. Nucleoside reverse transcriptase inhibitors...

To report the results of a questionnaire-based interventional study to evaluate the effects of strabismus surgery on private self-consciousness, public self-consciousness, and social anxiety using a validated self-consciousness survey instrument.Patients who underwent strabismus surgery completed a demographics and a self-consciousness scale form both pre- and postoperatively. The total and subscale (private self-consciousness, public self-consciousness, and social anxiety) summative scores were compared using the Wilcoxon signed-rank test, with statistically significant relationships defined as P 0.05. Total and subscale summative scores were analyzed as such and by strabismus type, years of education, and marital status.Overall improvement was found postoperatively in total scores (P = 0.012), public self-consciousness scores (P = 0.009), and social anxiety scores (P = 0.028). Although improvement was noted for the private self-consciousness subscale (P = 0.188), it did not reach statistical significance. Subdivided according to strabismic and demographic subgroups, significant improvement was only noted in esotropic patients, college graduates, married/living partner/widowed patients, and separated/divorced patients.This study suggests that beyond functional and cosmetic improvements, strabismus surgery can result in improved public self-consciousness and social anxiety, with greatest effect noted in esotropic, college graduates, and nonsingle patients.

Sulforaphane, a precursor of glucosinolate in cruciferous vegetables such as broccoli and cauliflower, has been shown to protect brain ischemic injury. In this study, we examined the effect of systemic administration of sulforaphane on retinal ischemic reperfusion injury. Intraocular pressure was elevated in two groups of C57BL/6 mice (n = 8 per group) for 45 min to induce retinal ischemic reperfusion injury. Following retinal ischemic reperfusion injury, vehicle (1% DMSO saline) or sulforaphane (25 mg/kg/day) was administered intraperitoneally daily for 5 days. Scotopic electroretinography (ERG) was used to quantify retinal function prior to and one-week after retinal ischemic insult. Retinal morphology was examined one week after ischemic insult. Following ischemic reperfusion injury, ERG a- and b-wave amplitudes were significantly reduced in the control mice. Sulforaphane treatment significantly attenuated ischemic-induced loss of retinal function as compared to vehicle treated mice. In vehicle treated mice, ischemic reperfusion injury produced marked thinning of the inner retinal layers, but the thinning of the inner retinal layers appeared significantly less with sulforaphane treatment. Thus, sulforaphane may be beneficial in the treatment of retinal disorders with ischemic reperfusion injury.

Background Diagnosis and treatment of thermal ocular injuries are often delayed because facial burns are usually associated with life-threatening injuries requiring immediate intervention. The purpose of the present study is to review the diagnosis and management of ocular complications associated with thermal burns in a tertiary care burn unit. Methods In this retrospective study, the charts of patients admitted to the Loyola University Medical Center Burn Unit between January 1993 and January 1996 were reviewed. Results Of the 1,461 patients who were admitted to the burn unit during that period, 155 (10.6%) required ophthalmic consultation. Sixty-one patients (4.2%) had ocular injury, the most common type being periorbital burn and edema followed by corneal involvement. Thirty-one of the 61 patients (51%) received consultation on the day of admission. Six of the 61 patients (10%) required surgical intervention. There was no correlation between number of days to consultation and need for surgical intervention. Patients requiring surgery were more likely to have suffered third-degree burns. Conclusion Because it is difficult to predict which patients suffering from thermal burns involving the eyes will require surgical intervention, ophthalmic consultation should be sought early.

Purpose To report visual results in pediatric patients with high anisometropia following aggressive amblyopia treatment using traditional methods. Methods Charts of one physician, JM, were reviewed at a major university medical center for all patients with anisometropia of eight diopters or greater. Patients ranged from children with severe unilateral high myopia due to retinopathy of prematurity to one infant with severe microphthalmos, acoria, and congenital cataract. Four patients were identified. Final Snellen acuities were reported from the patient's last clinic examination. Average follow-up period was four years. Results Final visual acuities of involved eyes ranged from line Snellen 20/60 to 20/20. One patient with severe microphthalmos, congenital acoria, congenital cataract, and anisometropia of 40 diopters achieved a final Snellen visual acuity of 20/40 OS. No patients developed visual loss in the normal eye due to patching. No patients were lost to follow-up. Conclusion Based on our observations, excellent visual outcomes may be achieved in pediatric patients with high anisometropia by aggressive use of conventional occlusion and refractive methods.

We describe the clinical course of a 9-year-old boy in whom a spontaneous dural cavernous sinus fistula developed. The patient initially presented with proptosis and conjunctival congestion believed to be caused by a cavernous sinus hemangioma and was prescribed oral prednisone. He subsequently developed pain, increased proptosis, and decreased vision. Emergent angiography revealed a dural cavernous sinus fistula, which was successfully embolized. This is the first case to our knowledge of a dural cavernous sinus fistula in a noninfant child that was treated successfully with embolization during angiography. J AAPOS 2000;4:383-5.

Amniotic band syndrome (ABS) is a rare disorder in which bands of mesoderm that emanate from the chorionic side of the amnion and insert on the fetal body can generate a wide variety of disfiguring and disabling malformations. It usually is sporadic, and the incidence is approximately 1 in 15,000 live births, and affected children typically require involvement of several pediatric surgical subspecialties. The authors describe a case of ABS with extensive craniofacial anomalies.

A patient receiving anticoagulant therapy, who had a history of neovascular glaucoma secondary to proliferative diabetic retinopathy, presented with sudden loss of vision. He was found to have a layered, posterior, intracorneal hemorrhage associated with a Descement membrane detachment. Deep intracorneal hemorrhage may result in patients who have neovascular glaucoma with probable deep corneal neovascularization, possibly aggravated by anticoagulant therapy.

Purpose A 37-year-old Hispanic man with a history of chronic myelogenous leukemia was first seen with fever and preseptal cellulitis of this right orbit after a tooth extraction. Methods The patient subsequently developed bilateral, severe peripheral ulcerative keratitis. He was treated with systemic antibiotics for a presumed underlying infectious cause. Several painful, necrotizing skin lesions developed over his face, trunk, and extremities. Results Repeated skin biopsies of the necrotizing lesions were consistent with pyoderma gangrenosum. Both the skin lesions and peripheral ulcerative keratitis responded dramatically to systemic prednisone. Conclusions Pyoderma gangrenosum should be included in the differential diagnosis of peripheral ulcerative keratitis.