Pediatric Multidrug-Resistant Disseminated Tuberculosis Presenting as Small Finger Tuberculous Osteomyelitis: A Case Report.

CASE: We report a case in the United States of a 12-year-old girl with multidrug-resistant tuberculous (MDR-TB) osteomyelitis of the hand managed with surgical debridement and second-line anti-TB therapy. The disease course was complicated by dissemination and multifocal progression. CONCLUSION: Despite early intervention, multidrug resistance makes TB treatment challenging and facilitated progression to disseminated disease in this case. We review the difficulties in diagnosis and treatment of pediatric MDR-TB.

Physicochemical properties of micellar casein retentates generated at different microfiltration temperatures.

Processing temperature has a significant influence on the composition and functionality of the resulting streams following microfiltration (MF) of skim milk. In this study, MF and diafiltration (DF) were performed at 4 or 50°C to produce ß-casein (ß-CN)-depleted and nondepleted (i.e., native casein profile) micellar casein isolate retentates, respectively. Microfiltration combined with extensive DF resulted in a 40% depletion of ß-CN at 4°C, whereas no ß-CN depletion occurred at 50°C. Microfiltration at 4°C led to higher transmission of calcium into permeates, with retentate generated at 4°C containing less total calcium compared with retentate generated at 50°C, based on the volume of retentate remaining. Higher heat stability at 120°C was measured for retentates generated at 4°C compared with those at 50°C, across all pH values measured. Retentates generated at 4°C also had significantly lower ionic calcium values at each pH compared with those generated at 50°C. Higher apparent viscosities at 4°C were measured for retentates generated at 4°C compared with retentates generated at 50°C, likely due to increased voluminosity of ß-CN-depleted casein micelles. The results of this study provide new information on how changing the composition of MF retentate, by appropriate control of processing temperature and DF, can alter physicochemical properties of casein micelles, with potential implications for ingredient functionality.

Radiocapitellar and Ulnotrochlear Pressures Increase in a Radial Head Fracture Model: A Cadaveric Biomechanical Analysis.

BACKGROUND: Changes in intra-articular pressure have not been previously described in relation to the management of radial head fractures. We hypothesized that pressure within the radiocapitellar and ulnotrochlear joints would increase with progressive radial head resection, mimicking a displaced radial head fracture, in a cadaveric model. METHODS: Ten cadaveric specimens were tested. Intra-articular pressure sensors were used to measure pressure within the radiocapitellar and ulnotrochlear joints with the forearm in full supination. The elbow was loaded to 100 N in extension, 45° of flexion, and 90° of flexion under the following conditions: (1) intact radial head, (2) 20% radial head resection, (3) 40% radial head resection, and (4) 100% radial head resection. RESULTS: The distribution of pressure between the radiocapitellar and ulnotrochlear joints did not change with sequential, partial resection of the radial head (radiocapitellar joint, between 48.92% and 53.79%; ulnotrochlear joint, between 46.21% and 51.08%). After 20% resection, radiocapitellar peak contact pressure (PCP) increased by 22% (from 1,410 to 1,721.5 kPa) and ulnotrochlear PCP increased by 36% (from 1,319 to 1,797.5 kPa). After 40% resection, radiocapitellar PCP increased by 123% (from 1,410 to 3,145 kPa; p = 0.0003) and ulnotrochlear PCP increased by 105% (from 1,319 to 2,702 kPa; p = 0.007). Ulnotrochlear PCP increased by a total of 159% after complete radial head resection (from 1,319 to 3,415.5 kPa; p = 0.003). CONCLUSIONS: Pressures in the radiocapitellar and ulnotrochlear joints were equally distributed with an intact radial head and after partial resection. Radiocapitellar and ulnotrochlear pressures increased with increasing radial head resection, significantly exceeding 100% of normal after radial head resection of 40% of the anterolateral diameter. LEVEL OF EVIDENCE: Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Posterolateral Rotatory Instability Develops Following the Modified Kocher Approach and Does Not Resolve Following Interval Repair.

BACKGROUND: The modified Kocher and extensor digitorum communis (EDC)-splitting intervals are commonly utilized to approach the lateral elbow. Iatrogenic injury to the lateral ulnar collateral ligament may result in posterolateral rotatory instability (PLRI). in the present cadaveric study, we (1) evaluated lateral elbow stability following the use of these approaches and (2) assessed the accuracy of static lateral elbow radiographs as a diagnostic tool for PLRI. METHODS: Ten matched-pair cadaveric upper-extremity specimens (n = 20) were randomly assigned to Kocher or EDC-splitting approaches. Specimens underwent evaluation pre-dissection, post-dissection, and following repair of the surgical interval. Clinical evaluation of lateral elbow stability was performed with the lateral pivot-shift maneuver. Radiographic radiocapitellar displacement was evaluated with the fully extended hanging arm test and on lateral elbow 30° flexion radiographs. Paired Wilcoxon signed-rank tests with Bonferroni correction were utilized to compare groups. RESULTS: All Kocher group specimens (10 of 10) developed PLRI on the pivot-shift maneuver following dissection. No EDC-splitting group specimens (0 of 10) developed instability with pivot-shift testing. The fully extended hanging arm test showed no difference in radiocapitellar displacement between groups (p > 0.008). Lateral elbow 30° flexion radiographs in the Kocher group showed an increased radiocapitellar displacement difference (mean, 8.46 mm) following dissection compared with the pre-dissection baseline (p < 0.008). Following repair of the Kocher interval, the radiocapitellar displacement (mean, 6.43 mm) remained greater than pre-dissection (mean, 2.26 mm; p < 0.008). In the EDC-splitting group, no differences were detected in radiocapitellar displacement on lateral elbow radiographs with either the fully extended hanging arm or lateral elbow 30° flexion positions. CONCLUSIONS: The Kocher approach produced PLRI that did not return to baseline conditions following repair of the surgical interval. The EDC-splitting approach did not cause elbow instability clinically or radiographically. The hanging arm test was not reliable for the detection of PLRI. CLINICAL RELEVANCE: The Kocher interval for lateral elbow exposure results in iatrogenic PLRI that is not detectable on the hanging arm test and that does not return to baseline stability following repair of the surgical interval.

Clinical Outcomes of Severely Angulated Fifth Metacarpal Neck Fractures Treated Nonsurgically.

BACKGROUND: Reasonable functional outcomes for nonoperative management of isolated, closed fifth metacarpal neck fractures with up to 70° angulation have been reported; however, reported outcomes for fractures with greater than 70° angulation are limited. This study describes clinical outcomes of nonsurgically treated fifth metacarpal neck fractures with angulation of greater than 70°. METHODS: A retrospective review of patients treated between May 1, 2016, and May 1, 2020, included: (1) patients aged 18 years and above with an isolated, closed, fifth metacarpal neck fracture; (2) nonsurgical treatment; (3) healed fractures with angulation greater than 70° measured on oblique radiographs; and (4) minimum 6-month follow-up after injury. Photographic hand motion and patient-rated outcomes (Functional Hand Scale, Quick Disabilities of the Arm, Shoulder, and Hand [QuickDASH], 12-item Short-Form Health Survey [SF-12]) were collected and reported. RESULTS: A total of 364 fractures were identified; 11% (40/364) demonstrated angulation of greater than 70° (range: 71°-82°); and 15 patients (inclusion rate: 38%, 15/40) with mean fracture angulation of 73° (range: 71°-77°) participated in the study. Mean follow-up was 32 months (range: 8-120 months), the dominant hand was injured in 87% (13/15) of patients, and 47% (7/15) of patients worked in manual labor. All patients scored the highest rating of "very good" (range: 26-30 of 30 points) on the functional hand scale. A QuickDASH score of zero (no morbidity) was reported in 80% (12/15) of patients. About 87% (13/15) of patients had average or above-average scores on the SF-12 (mean = 109, range: 84-115). CONCLUSIONS: Patients with healed, isolated, closed fifth metacarpal neck malunions with severe angulation greater than 70° demonstrated acceptable functional outcomes based on patient-rated outcomes scoring.

Cold Microfiltration as an Enabler of Sustainable Dairy Protein Ingredient Innovation.

Classically, microfiltration (0.1-0.5 µm) of bovine skim milk is performed at warm temperatures (45-55 °C), to produce micellar casein and milk-derived whey protein ingredients. Microfiltration at these temperatures is associated with high initial permeate flux and allows for the retention of the casein fraction, resulting in a whey protein fraction of high purity. Increasingly, however, the microfiltration of skim milk and other dairy streams at low temperatures (≤20 °C) is being used in the dairy industry. The trend towards cold filtration has arisen due to associated benefits of improved microbial quality and reduced fouling, allowing for extended processing times, improved product quality and opportunities for more sustainable processing. Performing microfiltration of skim milk at low temperatures also alters the protein profile and mineral composition of the resulting processing streams, allowing for the generation of new ingredients. However, the use of low processing temperatures is associated with high mechanical energy consumption to compensate for the increased viscosity, and thermal energy consumption for inline cooling, impacting the sustainability of the process. This review will examine the differences between warm and cold microfiltration in terms of membrane performance, partitioning of bovine milk constituents, microbial growth, ingredient innovation and process sustainability.

Physical and colloidal stability of conventional and micronised calcium citrate ingredient powders in the formulation of infant nutritional products.

The fortification of food systems with calcium remains difficult; one challenge is to maintain the colloidal stability of insoluble calcium salts during processing and shelf life. Particle size reduction of insoluble salts may result in improved product stability. In this study, insoluble calcium citrate in two different particle sizes, conventional calcium citrate and micronised calcium citrate, were first evaluated in terms of physical and bulk handling properties, followed by protein adsorption and colloidal stability when dispersed in two dairy-based nutritional beverages differing in composition, i.e. infant milk formula stage 1 and 3. Particle size distribution analysis showed micronised calcium citrate (volume-weighted diameter = 5.10 µm) to have significantly smaller (p < 0.05) particle size than conventional calcium citrate (volume-weighted diameter = 88.2 µm). The adsorption of dairy proteins onto particles of calcium citrate resulted in caseins having greater affinity for both salts, followed by ß-lactoglobulin. The smaller particle size of the micronised citrate resulted in higher affinity for casein and greater colloidal stability when dispersed in both infant milk formula solutions compared to conventional calcium salts. The results of this study provide knowledge on the application of micronised insoluble calcium salts in the fortification of nutritional dairy-based products.

Independent risk factors for recurrent or multiple new injuries in CrossFit athletes.

BACKGROUND: CrossFit is a relatively new sport with rapidly growing participation rates in the United States and around the world. We sought to determine risk factors for sustaining multiple CrossFit-related injuries requiring medical evaluation. METHODS: CrossFit-related musculoskeletal injuries evaluated at a single hospital system (N.=837) were identified. For musculoskeletal injuries, use of physical therapy, injection, advanced diagnostic imaging including CT or MRI, and surgery were documented. Independent risk factors for sustaining multiple injuries requiring medical evaluation were assessed by multivariate logistic regression analysis. RESULTS: A total of 94/837 (11.2%) underwent evaluation for 2 or more CrossFit-Related injuries (74% new injury to different body part; 26% subsequent injury, same body part). Independent risk factors for repeat injury (recurrent injury or second new injury) included increased length of follow-up (per year: OR 1.50 CI: 1.29, 1.75; P<0.001), initial injury during spring season (OR 2.03 CI: 1.27, 3.26; P=0.004), advanced imaging not obtained for evaluation of initial injury (OR 2.62 CI: 1.37, 5.02; P=0.002), course of physiotherapy completed for initial injury (2.00 CI: 1.17, 3.41; P=0.008), corticosteroid injection administered for initial injury (OR 2.43 CI: 1.21, 4.88; P=0.01), and increased age (per 5 year increase: OR 1.12 CI: 1.01, 1.24; P=0.03). These risk factors in combination had moderate discriminatory ability for identifying athletes at risk for multiple injuries. CONCLUSIONS: There are multiple risk factors for sustaining a recurrent or second new CrossFit-related injury requiring medical evaluation including older age, length of participation, and spring season participation. Risk factors for repeat injury related to initial evaluation and treatment include not receiving advanced imaging, receiving a corticosteroid injection, or undergoing physical therapy. The anatomic site of initial injury was not related to risk of subsequent injury in this population.

CrossFit-related hip and groin injuries: a case series.

To provide descriptive data on injury presentation and treatment and to identify risk factors for requiring surgical treatment for athletes presenting with CrossFit-related hip and groin injuries. CrossFit-related injuries (n = 982) were identified within a single hospital system from 2010 to 2017, with 83 (8.5% of total) identified hip or groin injuries. Patient demographics, injury diagnosis, surgical procedure and rehabilitation were assessed. Independent predictors of requiring surgery were analyzed via multivariate logistic regression analysis. Patients with hip or groin injuries were more often female (hip injuries: 63%; all injuries: 50%; P < 0.001) with mean age 34.3 years (standard deviation 10.9). Median symptom duration was 4 months with 70% reporting insidious onset. Most common diagnoses were femoral-acetabular impingement syndrome (34%), hamstring strain (11%), non-specific hip/groin pain (imaging non-diagnostic) (11%), hernia (7%) and iliotibial band syndrome (6%). Most (90%) required physical therapy (median 2 months). Surgery occurred in 24% (n = 12 hip arthroscopy, n = 5 inguinal hernia repair, n = 3 total hip arthroplasty), with 100% return to sport after arthroscopy or hernia repair. The only predictor of surgery was complaint of primarily anterior hip/groin pain (82% surgical patients, 46% non-surgical) (odds ratio 5.78, 95% confidence interval 1.44-23.1; P = 0.005); age, sex, body mass index, symptom duration and symptom onset (insidious versus acute) were non-significant (P > 0.25). CrossFit athletes with hip and groin injuries often present with prolonged symptoms with insidious onset. Most patients require several months of physical therapy and approximately one quarter require surgery. Patients presenting with primarily anterior hip/groin pain are at increased risk for requiring surgery. LEVEL OF EVIDENCE: IV, case series.

Interleukin-6 role in head and neck squamous cell carcinoma progression.

Interleukin-6 (IL-6) is a pleiotropic cytokine which plays an important role in a number of cellular processes including proliferation, survival, differentiation, migration and invasion. IL-6 mediates its downstream effects by activating a number of signaling cascades including JAK/STAT, PI3K/AKT and MAPK pathways. In addition to its effects on tumor cells, IL-6 also regulates tumor progression and tumor metastasis by modulating tumor angiogenesis and tumor lymphangiogenesis. A number of studies have shown that IL-6 levels are markedly upregulated in cancer patients. We and others have shown that high IL-6 expression independently predicts tumor recurrence, tumor metastasis and poor survival in head and neck cancer patients. Therefore targeting IL-6 signaling is a potential therapeutic strategy for the treatment of head and neck squamous cell carcinoma (HNSCC). In this review, we discuss the current understanding of the role of IL-6 in HNSCC progression and potential therapeutic strategies to target IL-6 signaling for the treatment of head and neck cancer patients.

Visual acuity and refraction by age for children of three different ethnic groups in Paraguay.

PURPOSE: To characterize refractive errors in Paraguayan children aged 5-16 years and investigate effect of age, gender, and ethnicity. METHODS: The study was conducted at 3 schools that catered to Mennonite, indigenous, and mixed race children. Children were examined for presenting visual acuity, autorefraction with and without cycloplegia, and retinoscopy. Data were analyzed for myopia and hyperopia (SE ≤-1 D or -0.5 D and ≥2 D or ≥3 D) and astigmatism (cylinder ≥1 D). Spherical equivalent (SE) values were calculated from right eye cycloplegic autorefraction data and analyzed using general linear modelling. RESULTS: There were 190, 118, and 168 children of Mennonite, indigenous and mixed race ethnicity, respectively. SE values between right/left eyes were nonsignificant. Mean visual acuity (VA) without correction was better for Mennonites compared to indigenous or mixed race children (right eyes: 0.031, 0.090, and 0.102 logMAR units, respectively; P<0.000001). There were 2 cases of myopia in the Mennonite group (1.2%) and 2 cases in the mixed race group (1.4%) (SE ≤-0.5 D). The prevalence of hyperopia (SE ≥2 D) was 40.6%, 34.2%, and 46.3% for Mennonite, indigenous and mixed race children. Corresponding astigmatism rates were 3.2%, 9.5%, and 12.7%. Females were slightly more hyperopic than males, and the 9-11 years age group was the most hyperopic. Mennonite and mixed race children were more hyperopic than indigenous children. CONCLUSIONS: Paraguayan children were remarkably hyperopic and relatively free of myopia. Differences with regard to gender, age, and ethnicity were small.

Visual acuity and refraction by age for children of three different ethnic groups in Paraguay / Acuidade visual e refração por idade para crianças de três grupos étnicos diferentes no Paraguai

PURPOSE: To characterize refractive errors in Paraguayan children aged 5-16 years and investigate effect of age, gender, and ethnicity. METHODS:The study was conducted at 3 schools that catered to Mennonite, indigenous, and mixed race children. Children were examined for presenting visual acuity, autorefraction with and without cycloplegia, and retinoscopy. Data were analyzed for myopia and hyperopia (SE ≤-1 D or -0.5 D and ≥2 D or ≥3 D) and astigmatism (cylinder ≥1 D). Spherical equivalent (SE) values were calculated from right eye cycloplegic autorefraction data and analyzed using general linear modelling. RESULTS: There were 190, 118, and 168 children of Mennonite, indigenous and mixed race ethnicity, respectively. SE values between right/left eyes were nonsignificant. Mean visual acuity (VA) without correction was better for Mennonites compared to indigenous or mixed race children (right eyes: 0.031, 0.090, and 0.102 logMAR units, respectively; P<0.000001). There were 2 cases of myopia in the Mennonite group (1.2%) and 2 cases in the mixed race group (1.4%) (SE ≤-0.5 D). The prevalence of hyperopia (SE ≥2 D) was 40.6%, 34.2%, and 46.3% for Mennonite, indigenous and mixed race children. Corresponding astigmatism rates were 3.2%, 9.5%, and 12.7%. Females were slightly more hyperopic than males, and the 9-11 years age group was the most hyperopic. Mennonite and mixed race children were more hyperopic than indigenous children. CONCLUSIONS: Paraguayan children were remarkably hyperopic and relatively free of myopia. Differences with regard to gender, age, and ethnicity were small.

OBJETIVO: Caracterizar os erros de refração em crianças paraguaias com idades entre 5 e 16 anos e investigar efeito da idade, gênero e etnia. MÉTODOS: O estudo foi realizado em três escolas que atendiam crianças de etnia Menonita, indígena e mista. As crianças foram examinadas em relação à acuidade visual, autorrefração com e sem cicloplegia, e retinoscopia. Os dados foram analisados ​​para correção de miopia e hipermetropia (EE ≤-1 D ou -0,5D e ≥ 2D ou ≥3 D) e astigmatismo (cilindro ≥1 D). Valores equivalentes esféricos (EE) foram calculados a partir dos dados de autorrefração cicloplegiada do olho direito e analisados ​​por meio de modelagem linear geral. RESULTADOS: Foram avaliadas 190, 118 e 168 crianças de etnias Menonita, indígena e mista, respectivamente. Diferenças entre os valores de EE de olhos direitos e esquerdos não foram significantes. A acuidade visual (AV) sem correção foi melhor para Menonitas em relação às crianças da etnia indígena ou mista (olho direito: 0,031, 0,090 e 0,102 logMAR, respectivamente; P<0,000001). Houve 2 casos de miopia no grupo Menonita (1,2%) e 2 casos no grupo de etnia mista (1,4%) (SE ≤-0,5 D). A prevalência de hipermetropia (SE ≥2 D) foi de 40,6%, 34,2% e 46,3% para as etnias Menonita, indígena e mista. As taxas correspondentes de astigmatismo foram de 3,2%, 9,5% e 12,7%. As mulheres foram ligeiramente mais hipermétropes do que os homens, e o grupo de 9 a 11 anos de idade foi a mais hipermétrope. Crianças da etnia Menonita e mista se mostraram mais hipermétropes do que as crianças indígenas. CONCLUSÕES: As crianças paraguaias são notavelmente hipermétropes e relativamente livres de miopia. Diferenças com relação ao sexo, idade e etnia são pequenas.

Charlie Brown, amblyopia, and me: A (not so short) personal history of the past forty years of diagnosing and treating amblyopia.

INTRODUCTION: During the past forty-plus years there have been many advances in our understanding of amblyopia. It has been my privilege to be able to have a close relationship with many of the people that made these contributions. It is the purpose of this paper to trace these changes as they developed from 1965 to the present. AMBLYOPIA THROUGH THE DECADES: 1950s and 1960s: Beginning with the introduction of electrodes that could record from a single cell in the mammalian visual cortex, researchers began to map out the normal physiology of the visual cortex, the lateral geniculate bodies and the retinal ganglion cells. Amblyopia, especially stimulus deprivation amblyopia, became a focus of many of these studies. As more and more information became available, clinicians began to understand the problems that they had been facing in such cases as congenital cataracts, unilateral congenital corneal opacities, etc. This led to a significant change in our approach to such cases with emphasis on earlier and earlier intervention to achieve better visual results. 1970S and 1980S: Scientific studies of patients using techniques such as Contrast Sensitivity Function, Teller Acuity Cards, and Neutral Density filters allowed us to begin to look at development of vision in infants, to characterize the differences between the various types of amblyopia and to better understand the need for amblyopia treatment. At about the same time, interest in vision screening in children allowed us to detect amblyopia at an earlier time of life, which then gave us a better chance of successful treatment. 1990S and the 21ST century: Arenewed interest in developing evidence-based results in keeping with the rest of the scientific medical community led to large multicenter trials looking at different modes of amblyopia treatment with the result of a wider armamentarium available to the practitioner. CONCLUSION: While there have been many improvements in our knowledge of the etiology of amblyopia and its treatment, we still find that it is the practitioner, the orthoptist, the patient's family, and the child that make the final difference in success or failure. However, our ability to explain what and why we are doing has made this job easier and given us the tools we need to feel confident in our approach to this still common condition.

Recruitment and manpower in pediatric ophthalmology and strabismus.

PURPOSE: Many have observed what appears to be declining interest on the part of ophthalmology graduates in pediatric ophthalmology and strabismus (PO&S) as a career. Four questions might address this concern: (1) Has there been a decline in the number of fellowship positions filled in the period 2000 to 2005? (2) Why do graduates choose other career paths? (3) Assuming there has been a decrease in interest in PO&S, does it reflect dissatisfaction on the part of pediatric ophthalmologists in their field? (4) What can be done to enhance the appeal of the subspecialty? METHODS: Data from the San Francisco Matching Programs covering the years 2000 through 2005 included the numbers of ophthalmology graduates, their subspecialty choices, the number of applicants to PO&S and other subspecialty fellowships, and the number of fellowship positions offered. Supplemental surveys assessed positions filled outside the match and international fellows. Factors influencing residents' career choices and the job satisfaction of pediatric ophthalmologists were analyzed in separate surveys. RESULTS: The number of fellowship positions in PO&S increased from 41 to 50 between 2000 and 2004. The number of graduates participating in the match has varied but remained the same (38) in 2005 as in 2000. Graduates were discouraged from PO&S by inadequate mentoring, by aversion to children, and by higher compensation in other fields. Pediatric ophthalmologists generally are highly satisfied in their careers, although financial compensation is a concern for many. CONCLUSIONS: Pediatric ophthalmologists should remain optimistic about recruitment but could enhance the appeal of PO&S by teaching more effectively and by promoting the field.

Sweep visual evoked potential testing as a predictor of recognition acuity in albinism.

OBJECTIVE: To determine if sweep visual evoked potential (VEP) acuity is predictive of recognition acuity in children with albinism. METHODS: A retrospective review was performed in children with albinism who underwent sweep VEP testing from 1992 to 2003. All patients had a complete ophthalmologic examination with either binocular or monocular sweep VEP testing and at least 5 years of follow-up. Positive predictability of sweep VEP acuity was defined as final recognition acuity within 1 Snellen line of initial sweep VEP acuity. RESULTS: Of the 13 patients included in the study, 11 had nystagmus, iris transillumination defects, and foveal hypoplasia at initial examination. The mean age at initial sweep VEP testing was 3.1 years (range, 0.1-10.0 years). Five of 13 patients had initial sweep VEP acuity that was predictive of final recognition acuity. Five additional patients had final recognition acuity, which surpassed initial sweep VEP acuity by 2 to 3 lines. Of these 10 patients, the mean duration for recognition acuity to reach VEP acuity was 5.4 years. There was no correlation between predictive VEP acuity and foveal pigmentation, refractive error, strabismus, nystagmus, or longer follow-up. CONCLUSIONS: Sweep VEP testing can be used as a predictive tool for recognition acuity in children with albinism. Predictability was found in a clinical spectrum of albinism.

Successful treatment of anisometropic amblyopia with spectacles alone.

BACKGROUND: The efficacy of treating anisometropic amblyopia with occlusion therapy is well known. However, this form of treatment can be associated with risks. Spectacle correction alone may be a successful and underutilized form of treatment. METHODS: The records of 28 patients treated successfully for anisometropic amblyopia with glasses alone were reviewed. Age, initial visual acuity and stereoacuity, and nature of anisometropia were analyzed to assess associations with time required for resolution, final visual acuity, and stereoacuity. Incidence of amblyopia recurrence and results of subsequent treatment, including patching, were also studied. RESULTS: Mean time to amblyopia resolution (interocular acuity difference