Biomedical subjects

J E Scharre

Publications and source records attributed to J E Scharre.

8 recordsLinked to original sources

PubMed1997

Visual anomalies in young children exposed to cocaine.

PURPOSE: The number of children exposed to cocaine in utero each year is increasing. Recent reports suggest significant visual anomalies in infants prenatally exposed to cocaine. The purpose of this retrospective study was to determine if children exposed prenatally to cocaine were at a greater risk for visual abnormalities, such as strabismus and significant refractive errors. METHODS: This pilot study was conducted at two sites, an outpatient clinic and a hospital-based practice. Consecutive files from January to July, 1993, of 79 children (aged 4 months to 94 months); who were identified by case history or meconium analysis information as being exposed to cocaine in utero, were reviewed. Fifty-five children met the inclusion criteria for the study. In addition, a control group of 100 pediatric patients were randomly selected from the pediatric patients seen at the outpatient clinical site. RESULTS: Of the 30 children from the Illinois Eye Institute (IEI) and the 25 children from The Children's Hospital (TCH), spherical refractive errors in the right eye ranged from +6.50 to -12.50 D. The median refractive errors were +0.75 and +0.50 D, respectively. No statistical difference was found in spherical refractive error, astigmatism, or anisometropia between the cocaine-exposed cohorts and the control group (N = 100). Strabismus was found in 15/55 (27%) of the children in the cocaine-exposed group. There was a statistically significant difference in the prevalence of strabismus between the cocaine-exposed group and the control group. Further analysis revealed that full birthweight (> 2500 g) children prenatally exposed to cocaine were at a greater risk for strabismus as compared to the full birthweight control group. Ocular abnormalities were rare, but included optic nerve atrophy and retinopathy of prematurity. CONCLUSIONS: These data suggest cocaine exposure during pregnancy may place a child at risk for conditions that may negatively impact the visual system, specifically strabismus.

Abnormalities, Drug-Induced↗

PubMed1996

Conjunctivitis associated with fifth disease in a child: a case report.

BACKGROUND: Erythema infectiosum, fifth disease, is a mildly contagious childhood illness that may present with viral conjunctivitis. It is characterized by a facial rash with a "slapped-cheek" appearance and "lacy-like" rash on the trunk and extremities. Fifth disease is believed to be caused by parvovirus B19. METHODS/RESULTS: A case of 10-year-old child with fifth disease and conjunctivitis is presented. CONCLUSIONS: The progression, differential diagnosis, and management of fifth disease are reviewed.

Anterior Chamber↗

PubMed1994

Pediatric clinical decision making.

BACKGROUND: Clinicians systematically gather information and data, generate hypotheses, and using clinical judgment arrive at a diagnosis and treatment plan. This process may be difficult and time consuming. Analysis using decision-making algorithms provides the clinician with a model to simplify complex clinical situations. This decision-making strategy is particularly effective in the pediatric population because of the variability in the patient's responses. METHODS: This clinical strategy is presented for two clinical scenarios in pediatric patients, nystagmus and esotropia. Two clinical decision-making trees are presented with possible clinical approaches to problem solving. CONCLUSIONS: Decision analysis in the care of pediatric patients may be simplified by the development of decision-making algorithms. This explanation of the decision-making strategy will allow clinicians to develop a personal approach to problem solving in their clinical care.

Algorithms↗

PubMed1992

Assessment of visual function in autistic children.

Children with autism demonstrate "atypical" gaze or social "looking" and frequently manifest such sterotypies as eye pressing, hand flicking, and light gazing. This study's purpose was to evaluate autistic children for visual dysfunction that may be related to the manifested visual signs and symptoms. Thirty-four autistic children, ages 2 to 11 years (median age = 7 years, 6 months) were evaluated for ocular alignment, refractive error, visual acuity, oculomotility skills, and stereopsis. None of the children manifested ocular disease, known seizure disorders, or dysmorphic features. Their developmental levels ranged from average intelligence to severely retarded. Binocular visual acuity was measured with the acuity card procedure. Monocular visual acuity was not obtained. Refractive errors ranged from -4.25 to +3.25 D; the median was plano with the near retinoscopy technique. Of the 34 children, 21% were strabismic at far and 18% were strabismic at near. Lang stereo testing was attempted on all children and completed on 17. Of the 17, all but 3 exhibited 550 sec arc. Only 14.7% of the children exhibited voluntary pursuit movements, and all the children demonstrated saccadic fixations. Thirty-one children had atypical optokinetic nystagmus (OKN) responses such as delayed onset, short duration, gaze avoidance, or stereotypic behavior. Repeated testing revealed consistent visual responses on OKN and visual acuity. Given these findings, research with this population should be pursued further.

Autistic Disorder↗

PubMed1992

Retinopathy of prematurity--review of the pathophysiology and classification.

This paper provides an update on current concepts concerning retinopathy of prematurity (ROP). It considers the history, risk factors and pathophysiology of ROP as well as clinical recognition of the condition. The paper also describes the approved method of classification of the disease and presents treatment options.

Fundus Oculi↗

PubMed1990

Comparison of disparometer fixation disparity curves as measured with and without the phoropter.

Traditionally, Disparometer fixation disparity curve (FDC) measurement has been performed using a phoropter, although more recently some clinicians have suggested that the Disparometer be used outside the phoropter. Whereas vertical fixation disparity (FD) measurements have been found to correlate well when obtained with and without a phoropter, there is currently no evidence that horizontal FDC's are similar in the two testing situations. A FDC was plotted for 30 visually asymptomatic young adults both in and out of the phoropter. Statistical analysis revealed no significant differences between results on the basis of curve type, slope, y- or x-intercept; however, noteworthy individual variations did occur. Therefore, we conclude that consistency of testing method is important when serial curves are plotted for a given patient. Although each method has some advantages and disadvantages, neither is clearly superior based on this study.

Adult↗

PubMed1990

Normative contrast sensitivity data for young children.

Contrast sensitivity (CS) was measured in children ages 3 to 7 years using the Vistech Contrast Sensitivity distance chart (VCTS 6500). The purpose of the study was to determine how effectively the technique could be used with young children and to establish normative data for this age group. Of 286 children participating in a vision screening, the contrast sensitivity function (CSF) was measurable on 241 (84%) under binocular conditions and 229 (80%) under both binocular and monocular conditions. The 219 binocular CSF's and 208 monocular CSF's obtained from visually normal children were used to establish normative data and then compared to similar data from 50 visually normal young adults. The results indicated that there is an effect of age between 3 and 7 years, children are significantly less sensitive than adults, and adult-like levels of CS are not yet reached at 7 years of age. In addition, although the children's mean contrast thresholds fell within the norms provided with the VCTS 6500, the variability in the children's CSF's precludes using the Vistech data for diagnostic purposes in the young. The normative data are presented to assist the clinician in evaluating CS in young children when using the VCTS 6500.

Adult↗

PubMed1989

Poland-Möbius syndrome: a case report.

The Poland-Möbius syndrome is a combination of two rare congenital syndromes with an estimated prevalence of 1:500,000. It is characterized by a nonprogressive bilateral facial paralysis, the inability of the eyes to abduct beyond the midline, orofacial anomalies, limb deficiencies, and an absence or hypoplasia of the pectoral muscles.

Child, Preschool↗