5^thGlobal Pediatric Ophthalmology Congress March 02-03, 2020 Rome, Italy

Biography:

Verlyn Yang is a junior doctor in Ophthalmology practicing in a tertiary hospital in Queensland, Australia. Multiple tertiary sub-specialty services are provided in the center. Verlyn is actively pursuing a career in Outreach Ophthalmology.

Abstract:

Purpose and Aim: There has been an increasing trend towards utilising ultra-wide field, non-contact fundus photography systems like the Optos P200DTx, especially in paediatric patients. As a challenging opulation, this requires the use of techniques such as modification of the equipment, development of specific holds and positioning of the child. We describe the specific techniques utilised to take fundus photos on the Optos P200DTx for paediatric patient groups, 0-1 years, 1-3 years and and above 3 years old.

Methods: A systematic literature review of techniques used to image paediatric a patient on the Optos P200DTx was conducted, case reports studied, and expert opinions consulted. For primary data collection, parents were consented for clinical digital images and video recordings to be taken of their child undergoing Optos imaging in a tertiary hospital Ophthalmology clinic. The subsequent media was analysed and compared with the current literature, to develop specific techniques for each age group, 0-1 years, 1-3 years and & above 3 years old.

Results: Photos displaying the specific techniques were illustrated, accompanied by step-by-step descriptions of the methodology. The ‘Flying Baby’ position, ‘Back-to-face’ position and kneeling/seated position were employed for each respective age group.

Conclusion: These results support the use of the Optos P200DTx for fundus photography in paediatric patients of all ages, provided, tailored techniques are utilised.

Biography:

Jiang Lin is a Chief physician.  He is a member of the standing committee of visual health care branch of Sichuan preventive medical association; A senior member of IAOA; Deputy director of Aier eye hospital in Sichuan province. He has over thirty years of clinical experience. He is an expert in strabismus surgery, treatment of refraction, especially for children and Orthokeratology

Abstract:

Purpose: To investigate the diagnoses and surgical outcomes of acute acquired comitant esotropia (ACCE) with similar symptoms who were associated with myopia.

Methods: The data of the 84 cases, who received treatments for esotropia in the Aier eye hospital between February 2014 and February 2019, were collected. The age of them was 12～18 years, and 44 patients were male. Preoperatively, patients complained diplopia. All they were homonymous diplopia and no difference in different diagnostic eye positions; Eye movements were normal; Prism test was +15～+45 prism diopters(PD); The angle of deviation at distance was more than 10PD greater than that at near; Cycloplegic refraction was -1.00～-5.00D. No one had neurological diseases. After six months of follow-up, we did the medial rectus (MR) weaken procedure with lateral rectus (LR) strengthen procedure.

Results: Diplopia disappeared, and eye positions turned to normal postoperatively. Meanwhile no regressions appeared during six-month reviews.

Conclusion: These patients had similar symptoms (e.g. normal eye movements, diplopia especially at distant, etc.). According to these they were diagnosed as ACCE [1]. Besides, they had other same features like low to moderate myopia and wearing glasses all the time. Therefore, ACCE associated with myopia could be a better diagnosis. The onset of this disease related to near-work directly leads to convergence excess and divergence insufficiency. Apparently, visual training is not a preferred treatment of divergence insufficiency, and surgery for this kind of esotropia would be better. Compared with other doctors, we rarely use the MR weaken procedure only. Our surgeries mainly strengthen LR with slight weakening MR. We just strengthen LR with people less than 15PD at near. By this way, patients with Preoperative diplopia, normal binocular visual function, get pretty surgical outcomes.

Biography:

Vinita Gupta is working as an additional Professor in Department of Ophthalmology at All India Institute of Medical Sciences, Rishikesh, India. She also have published many article in reputed journals.

Abstract:

Although dramatic advances have occurred in the field of paediatric cataract surgery over the last decade, calculating and selecting an optimum intraocular lens for the small eye of a growing child is a unique challenge. The need to implant a fixed power lens into the eye that is still growing makes it difficult to choose an optimum IOL power that best suits the child’s eye. The younger the child, the more difficult it is.

What are the issues we encounter? Just as a child’s body grows after birth through adolescence, so does the child’s eye from infancy till adult life. Moreover, as regards the amount of myopic shift, just as some children grow faster than others, some eyes grow faster than others. And there are no factors that clearly indicate which eye will grow faster than others. So there is large variability in myopic shift and difficulty in predicting future (target) refraction for any given child.

Then comes the issue of measuring axial length and keratometry measurement in children, can be as difficult as unattainable in the office setting – most children need an EUA. Then the question – which IOL formula is to be used for children? Since these are short eyes, all the formulas are slightly inaccurate.

Then comes the influence of genetic behaviour of the refractive error in the parents, which can again not be predicted with accuracy. It has been noted that if both parents are myopic, 30-40% of children become myopic whereas if only one of the parents is myopic, 20-25% of children will become myopic. If none of the parents is myopic, then 10% of children become myopic, so it depends upon genetic influence, and it is therefore unpredictable.

The undercorrection guidelines and power calculation methods therefore vary according to the age of the child and there has been changing trends towards implanting IOL in even infants. Also methods  for piggyback IOLs and secondary IOLs  implantation have evolved, but with their own merits and demerits.

In summary, choosing an IOL for paediatric patients is not a child’s play, and the surgeon has several considerations to keep in mind in order to give optimal vision children with pediatric cataracts.

Biography:

Aisling McGlacken-Byrne is currently a Senior House Officer in her first year as an Ophthalmology Surgical Trainee in Sligo University Hospital. She has special interests thats include rural and remote medicine and health inequity. Her previous employment was a resident with the Lions Outback Vision Van, part of the Lions Eye Institute. The Lions Outback Vision Van is a mobile eye health clinic launched in 2016 which travels around Western Australia providing specialist eye health services to remote communities

Abstract:

Gliomas are the most common paediatric tumours of the central nervous system, exhibiting a broad range of clinical behaviours depending on origin, size and pathological subgroup. Knowledge of current and evolving advances in molecular characterization of this tumour is needed to ensure effective management. A 2-year-old boy presented with nystagmus since 10 months of age. Parents described initially left eye moving horizontally then right eye moving horizontally, then both with a vertical component. Poor vision was reported, with running into objects and difficulty recognizing people far away. He was otherwise well, normal term vaginal delivery and reaching developmental milestones. On examination the boy had high frequency, small amplitude see-saw nystagmus. It had no null point and no change with convergence or fixation. He had no anomalous head position and a normal red reflex with clear corneas. Dilated exam under general anaesthetic revealed left subtle nerve pallor and atrophy. Magnetic resonance imaging revealed a large optic nerve glioma originating from the optic nerve chiasm, spreading anteriorly and posteriorly. Our case documents see-saw nystagmus in a patient with likely bi-temporal hemianopia due to a large tumour but without mesencephalic compression or CSF dissemination. Because preschool children rarely complain about poor vision, by the time symptoms manifests, the disorders of vision have already progressed. Early diagnosis is paramount in diagnosing these often silently enlarging optic pathway gliomas.

Biography:

Zhao Xiquan is working as Shaanxi Ophthalmic Medical Center, Xi’an No. 4 Hospital, Affiliated Guangren Hospital, School of Medicine, Xi'an Jiaotong University, Xi’an, China

Abstract:

Results: The fundus examination showed retinal folds in both eyes, and the retinal vessels were pulled straight, the retina of the left eye was removed from 1 to 8 o'clock, and the peripheral hole was at 5 o’clock. The silicone tape was pressed from the 4 to 6 o'clock pad at the anterior equatorial hole. Intraoperative combined retinal drainage. Postoperative follow-up observation of subretinal fluid absorption, and the retinal are flat.

Conclusion: In patients with a history of premature birth, features of fundus examinations do not correlate with the occurrence of a retinal detachment. Repair of detachment in such a patient is more likely to require multiple procedures. Physicians should consider widespread relief of vitreoretinal traction for detachment in any patient with a history of premature birth.

Biography:

Jiwen Yang got a master's degree of Strabismus and Pediatric ophthalmology in 2005, then obtained PhD of Optometry from China Medical University in 2008. She engages in clinical work and scientific research, especially in diagnosis and treatment of strabismus, amblyopia and refractive error. She has completed tens of thousands strabismus correction surgery, including horizontal, vertical and rotating strabismus correction, and has fitted with Ortho-K lense and RGP for tens of thousands patients with myopia or astigmatism. She is the master tutor of Central South University, had completed mang provincial projects, received two items of Shenyang new technology awards, two projects sponsored by Health Development Planning Commission of Hunan province participated in formulating professional criteria of diagnosis and treatment criteria of strabismus of national third-level hospital, making many times of presentation in domestic and foreign academic conferences doing academic communication to the United States, Japan and so on.

Abstract:

Purpose: To review and analyze surgical outcomes of patients with Bielschowsky type acute acquired concomitant esotropia (AACE).

Methods: Retrospective study. We enrolled 9 esotropia and diplopia patients with myopia who performed strabismus surgery in Shenyang Aier Eye Hospital between June 2018 and March 2019, including 4 males, 5 females. The mean age of the patients was 22.67±5.41 (range, 16-30) years. They underwent monocular Medial Rectus Recession and Lateral Rectus Resection (6 cases), monocular Lateral Rectus Resection (3 cases).

Results: 1.The mean time of esotropia and diplopia onset: 22±15.59 (range, 6-48) months. 2. Incentives and treatment history: Excessive near working (2 cases), acupuncture treatment (3 cases), others with no treatment.3.The mean refractive errors in the right and left eyes were -4.05±1.34 (range,-2.25~-6.50) and -3.52±0.98 (range,-2.00~-5.25) diopters (D), respectively. 4. The mean AC/A value: 2.04±1.10 (range,0.67~4).5.Esodeviations: Average preoperative esodeviations at near and distance were 22.67±12.41(range,14~48) and 29.11±9.27(range,18~46) PD, average postoperative esodeviations at near and distance were 0 and 0.44±1.33(range,0~4)PD. There were significant statistically difference between preoperative and postoperative esodeviations both at near (T=5.48，P＜0.01) and distance (T=8.65，P＜0.0 1), respectively.6.The mean Medial Rectus Recession 2.44±1.94 (range,0-5) mm, 3 cases had dominant diplopia at distance, so they underwent monocular Lateral Rectus Resection, the mean Lateral Rectus Resection 4. 89±0.78 (range,4-6) mm.7.Diplopia: 9 patients all had diplopia preoperatively, all disappeared postoperatively. 8. Stereopsis: 5 patients had no stereopsis before surgery, 3 cases regained stereopsis after surgery.

Conclusions: In case of patients with Bielschowsky type AACE, surgery is the main treatment, patients achieved successful surgical alignment and the diplopia vanished as well. For patients with myopia, they should control the near work moderately.