Ophthalmology manifestations of pediatric cancer treatment.

PURPOSE OF REVIEW: Advances in pediatric oncology care have increased survival rates for children with malignancy. As a result, ophthalmologists are seeing more short-term and long-term complications associated with the treatment of these conditions. Ophthalmologists need to be aware of cancer treatment-related eye disorders. RECENT FINDINGS: Multiple eye findings are associated with cancer treatment, including chemotherapy, radiation, bone marrow transplantation, and newer modalities such as intra-arterial chemotherapy. Malignancy and treatment cause immunodeficiency that can lead to infectious disease manifestations, including eye involvement. Our understanding of the prevalence of eye involvement in infectious diseases is changing due to newer antimicrobial treatment modalities and earlier screening. Paraneoplastic conditions may manifest with eye findings either before the diagnosis of the primary malignancy or as a late finding. The evolution of IVF has raised concerns of increased cancer risks, including ocular tumors. SUMMARY: Ophthalmologists who are involved with the care of children undergoing cancer treatment need to be aware of the many eye manifestations that may result.

Update on retinopathy of prematurity: treatment options and outcomes.

PURPOSE OF REVIEW: To evaluate and review the recent scientific literature on retinopathy of prematurity (ROP). Recent studies have shown advancement in treatment options in ROP as well as improved functional and structural outcomes. This review compiles some of these recent findings. RECENT FINDINGS: New guidelines on ROP screening and treatment criteria have recently been developed and are now the standard of care for practitioners taking care of children having ROP. Recent advances in antiangiogenic therapies offer possible primary or adjunct treatment to the well established and effective laser treatment options. Follow-up of treated ROP patients informs us of the short-term and long-term complications requiring lifetime ophthalmology care. SUMMARY: This review offers an update on the screening and treatment guidelines, new treatment options, and short-term and long-term complications in ROP.

Arachnoid cyst resulting in sixth nerve palsy in a child.

A 2 year old presented with incomitant esotropia and abduction deficit consistent with sixth nerve palsy. Neuroimaging revealed an arachnoid cyst on the left. Neurosurgical shunting followed by strabismus surgery relieved the abduction deficit and esotropia. An arachnoid cyst may be a rare cause of acquired sixth nerve palsy and strabismus in children.

Systematic approach to pediatric ocular trauma.

PURPOSE OF REVIEW: The aim of this article is to evaluate and review the scientific literature on pediatric ocular trauma from the past several years. Recent advancements have recognized mechanisms of injury that may be unique to children, require different treatment course than adults, and raise multiple public health concerns. RECENT FINDINGS: Epidemiologic studies have shown that ocular trauma is a major cause of monocular blindness and potential disability in children worldwide. The mechanisms of injury are quite variable and often found under mundane circumstances. Orbital fractures in children are more likely to cause entrapment of orbital contents due to the structure of orbital bones at an early age and require earlier surgical repair. The management of traumatic hyphema responds well to outpatient care and topical aminocaproic acid. The management of traumatic cataracts has been enhanced with new iris-fixated lens implants. Endophthalmitis after ocular trauma carries a significantly worse prognosis, which may be reduced by early referral and intervention. SUMMARY: This review broadens our understanding of the mechanisms, treatment, and prognostic indicators in pediatric ocular trauma. This will allow improved clinical care of these injuries.