The pediatrician's role in reading disorders.

This article summarizes clinically pertinent information on dyslexia and various disorders that contribute to school failure. Clinical, school, and research findings related to dyslexia are discussed. The role of the eyes, visual system, and controversial therapies are explored. The author emphasizes the role of the pediatrician as a team leader on the multidisciplinary approach to the diagnosis, therapy, and counseling of children with learning disabilities.

Learning disabilities and vision problems: are they related?

Vision problems can interfere with the process of learning. However, vision problems are not the cause of learning disabilities. If a child or adolescent is diagnosed as having a learning disability, refraction and eye muscle function must be assessed. If no disorders are found or, if found and corrected, the treatment of choice for the learning disability is special education.

Effect of bright light in the hospital nursery on the incidence of retinopathy of prematurity.

The preterm infant is subjected to prolonged exposure to ambient nursery illumination at levels that have been found to produce retinal damage in animals. We prospectively investigated the effect of exposure to light in two intensive care nurseries by comparing the incidence of retinopathy of prematurity among 74 infants from the standard bright nursery environment (median light level, 60 foot-candles [ftc]) with the incidence among 154 infants of similar birth weight for whom the light levels were reduced (median, 25 ftc). There was a higher incidence of retinopathy of prematurity in the group of infants who had been exposed to the brighter nursery lights, particularly in those with birth weights below 1000 g (86 percent vs. 54 per cent, P less than 0.01 by chi-square test). We conclude that the high level of ambient illumination commonly found in the hospital nursery may be one factor contributing to retinopathy of prematurity and that safety standards with regard to current lighting practices should be reassessed.

Unusual eye abnormalities associated with congenital cytomegalovirus infection.

Seven children with congenital cytomegalovirus infection demonstrated a higher than expected incidence of "rare" ophthalmological abnormalities, including anophthalmia and Peters' anomaly. These data suggest that appropriate investigation for evidence of cytomegalovirus infection should be instituted in any child with congenital ocular defects.

Clinical anophthalmia associated with congenital cytomegalovirus infection.

Three cases of congenital clinical anophthalmia associated with congenital cytomegalovirus infection were diagnosed by positive viral cultures and immunologic studies. Ultrasonography in one infant with clinically detected anophthalmia showed the presence of severe microphthalmia with cyst. These findings suggest that maternal infection occurred within the first trimester of gestation.

Battered child syndrome simulating congenital glaucoma.

A 9-week-old child with "congenital glaucoma" was later found to have, in addition to enlarged corneas and elevated intraocular pressure, subluxated and cataractous lenses, hyphema, iridodialysis, angle recession, and vitreous hemorrhage, along with signs of gross parental neglect and physical abuse. To our knowledge, this is the first report in which a battered child with bilateral "congenital glaucoma" (probably caused by trauma) is described.