A large-scale analysis of refractive errors in students attending public primary schools in Mexico.

A cross-sectional, retrospective study was conducted from September 2013 through July 2014 to determine the prevalence of refractive errors among students attending public primary schools in Mexico. Among 3,861,156 students at 14,566 public primary schools in all 32 states of Mexico, teachers identified reduced visual acuity in 1,253,589 (32.5%) using visual acuity measurement. Optometrists confirmed 391,498 [31.2%, mean (SD) age: 8.8 (1.9) years; 204,110 girls (52.9%)] had refractive errors using visual acuity measurement and noncycloplegic static retinoscopy. Among 288,537 (72.4%) of children with previous eyeglasses usage data reported, 241,505 (83.7%) had uncorrected refractive errors. Before prescription eyeglasses were provided, 281,891 students (72%) had logMAR visual acuity ≤ 0.2; eyeglasses corrected vision loss in 85.6% (n = 241,352) of them. Simple myopic astigmatism was the most frequent refractive error (25.7%, n = 100,545). Astigmatism > - 1.00 diopters was present in 54.6% of all students with ametropia. The anisometropia rate based on spherical equivalent difference between right and left eye ≥ 1.50 diopters was 3.9% (n = 15,402). Uncorrected refractive errors are an important issue in primary school students in Mexico. An updated study is needed to analyze the evolving trends over the past decade.

Retinoblastoma seeds: impact on American Joint Committee on Cancer clinical staging.

AIM: To investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding. METHODS: Multicentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method. RESULTS: Clinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; p<0.001). There was insufficient evidence to prove or disprove an association between vitreous seed type and local treatment failure risk(p=0.06). CONCLUSION: This international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.

Toxocariasis ocular: tratamiento médico y quirúrgico

La toxocariasis es una parasitosis de distribución mundial que afecta principalmente a niños y adolecentes. El globo coular es afectado en su segmento posterior, existiendo varias presentaciones clínicas. Este trabajo describe retrospectivamente 4 pacientes con un diagnóstico clinico y serológico de toxocariasis ocular. Los pacientes fueron tratados médicamente con albendazol y prednisona. El tratamiento quirúrgico consistió en vitrectomía y membranectomía. Los resultados visuales dependieron del sitio y tipo de lesión encontrada en la retina que condicionó la posibilidad de tratamiento quirúrgico, y no del tipo de evolución de la enfermedad.

Tratamiento del glaucoma de difícil control en pediatría con válvula de Ahmed / Uncontrolled glaucoma pediatric treatment with Ahmed valve implant

Presentamos los resultados iniciales con el uso de la válvula de Ahmed, en el tratamiento de cinco pacientes pediátricos (seis ojos), con antecedente de cirugías de glaucoma previas insatisfactorias. Durante el periodo de seguimiento (5 a 34 meses), ningún paciente presentó complicaciones que ocasionaran disminución de la agudeza visual, alteraciones de la movilidad ocular o rechazo al dispositivo. Cuatro pacientes tuvieron disminución adecuada de la presión intraocular. Concluimos que la válvula de Ahmed es una opción viable en el manejo del glaucoma de difícil control en pediatría

Luxación de cristalino como presentación del síndrome del niño maltratado / Lens dislocation as a presentation of child abuse syndrome

El síndrome del niño maltratado o de Kempe es uno de los problemas más serios encontrados en el servicio de urgencias en pediatría, y las manifestaciones oculares son encontradas en la mayoría de los niños que sufren abuso físico.Se trata de un niño de 13 semanas de edad quien presenta trauma facial que le provoca luxación del cristalino, glaucoma y aumento de volumen del globo ocular derecho, presenta además fractura de fémur derecho antigua con encefalomalacia asociada, siendo manejado para evitar el desprendimiento de retina con vitrectomía pars plana y lensectomía.La luxación del cristalino debe ser considerada en el diagnóstico del síndrome de Kempe. Enfatizamos la necesidad de hacer un examen oftalmológico completo en cada caso donde se sospeche maltrato infantil.