Biomedical subjects

P M Edelman

Publications and source records attributed to P M Edelman.

12 recordsLinked to original sources

PubMed1997

Visual outcome in high hypermetropia.

INTRODUCTION: We wished to determine whether final visual acuity is dependent on age at optical correction or presence of esotropia in children with bilateral high hypermetropia. METHODS: We reviewed the charts of all patients at Childrens Hospital Los Angeles Division of Ophthalmology with bilateral hypermetropia of greater than or equal to 5D who were able to provide objective visual acuity outcomes with Snellen letters or linear E. RESULTS: One hundred thirteen patients met entry criteria. The age at first optical correction ranged from 8 months to 141 months (average 45 months). Initial visual acuity (before optical correction) was obtainable in 82 patients. Initial visual acuity ranged from 20/20 to 20/200, with 57% of patients having acuity better than or equal to 20/40. Final visual acuity (after optical correction) ranged from 20/20 to 20/70, with 109 patients (96%) having acuity better than or equal to 20/40 and 104 patients (92%) having acuity better than or equal to 20/30. There was no relationship between final visual acuity and age that spectacles were first worn. Ninety-five patients (84%) had esotropia with or without glasses, and six of these (6%) had final visual acuity less than 20/30. Of the 18 patients with orthotropia, three (16%) had final visual acuity less than 20/30. The prevalence of ametropic amblyopia in patients with esotropia and orthotropia was not significantly different (p = 0.18). CONCLUSION: Visual acuity outcome in children with high hypermetropia is generally good regardless of age at initial optical correction or presence of strabismus. A significantly increased risk for ametropic amblyopia was not found in those patients with orthotropia.

Age Factors↗

PubMed1994

High-grade stereo acuity after early surgery for congenital esotropia.

OBJECTIVE: To evaluate the effectiveness of very early surgery for establishing straight eyes and sensory fusion in patients with congenital esotropia. DESIGN: A review of consecutive patients with congenital esotropia who underwent surgery between 13 and 19 weeks of age. SETTING: A children's hospital with a teaching affiliation. PATIENTS: Seven patients who had surgery between 13 and 19 weeks of age. INTERVENTION: A bilateral medial rectus recession through a fornix incision with recessions ranging from 5.75 to 6.5 mm in infants younger than 6 months of age. MAIN OUTCOME MEASURES: Sensory fusion as measured by stereo acuity and Worth four-dot testing and motor alignment within 8 prism diopters. RESULTS: Five of the seven patients achieved essentially straight eyes with tropias of less than 8 prism diopters after one horizontal surgery. Five patients cooperated with sensory testing, and all showed stereo acuities that ranged from 400 to 40 seconds of arc. Three children had evidence of high-grade stereo acuity by showing stereopsis on random dot stereograms (Randot, Stereo Optical Co, Chicago, Ill) and by fusing the Worth four-dot test at distance and near range. Two of the patients with high-grade stereo acuity achieved a stereo acuity of 40 seconds of arc by Titmus testing; however, one had a late reduction of stereo acuity to 70 seconds of arc. CONCLUSION: Very early surgery can result in excellent motor alignment and high-grade stereo acuity in some patients with congenital esotropia.

Depth Perception↗

PubMed1992

Binocular fusion and stereopsis associated with early surgery for monocular congenital cataracts.

Despite improved visual acuity results in infants undergoing early surgery for monocular congenital cataracts, virtually all reports indicate a lack of binocular vision and the presence of strabismus in these patients. We report herein the presence of motor fusion and stereopsis in patients who have undergone early surgery for monocular congenital cataracts. Of 13 patients with congenital cataracts who were operated on by age 9 weeks, five (38%) had essentially straight eyes and evidence of motor fusion with a minimum of 1 year of follow-up. Three (60%) of five patients demonstrated sensory fusion, two with Titmus testing and one with Randot Stereo Acuity (Stereo Optical Co Inc, Chicago, Ill) of 250 seconds of arc. We conclude that binocular fusion and stereo visual acuity are obtainable in patients with monocular congenital cataracts.

Cataract↗

PubMed1986

Reliability of fixation preference testing in diagnosing amblyopia.

We evaluated the sensitivity and specificity of standard fixation preference testing and the 10-prism diopter (PD) fixation test in 427 patients. Standard fixation preference testing showed good sensitivity and specificity for than 10 PD. Patients with small angle tropias, however, had a high false-positive rate, with 40% of nonamblyopic patients inappropriately responding with strong fixation preference. The 10-PD fixation test reduced this high false-positive rate and showed only 1.5% false-positive results. Unfortunately, this shift to equal fixation preference was also seen in some patients with amblyopia, as five of 19 patients with three or more lines difference alternated fixation with the 10-PD fixation test. Retesting disclosed that, although these children would briefly alternate to the amblyopic eye while viewing a stationary target, they would not hold fixation with the amblyopic eye through smooth pursuit. Our conclusion is that standard fixation preference testing can be used to diagnose moderate to severe amblyopia in patients with tropias greater than 10 PD. Patients with small angle deviations or straight eyes should be examined with the 10-PD fixation test, with the criterion for equal vision being the ability to hold fixation well with either eye through smooth pursuit.

Amblyopia↗

PubMed1978