Amy K. Hutchinson

• Emory University

Importance Increased myopic shift was found to be associated with 1 year of overminus spectacle treatment for children with intermittent exotropia (IXT). Persistence of myopic shift after discontinuing overminus spectacles is unknown. Objective To compare refractive error change over 3 years in children with IXT originally treated with overminus v...

Purpose: To determine success rates over time for strabismus surgery for sensory exotropia and to determine factors associated with successful outcomes. Methods: We retrospectively reviewed medical records patients with sensory exotropia (best-corrected visual acuity ≤20/200 in the affected eye) who underwent strabismus surgery between May 2009...

Purpose: To report 2-year ocular and developmental outcomes for infants receiving low doses of intravitreal bevacizumab for type 1 retinopathy of prematurity (ROP). Methods: A total of 120 premature infants (mean birthweight, 687 g; mean gestational age, 24.8 weeks) with type 1 ROP were enrolled in a multicenter, phase 1 dose de-escalation study...

Background: Extremely preterm (EPT) birth has been related to dysregulation of stress responses and behavioral/learning problems at school age. Early adverse experiences can blunt HPA axis reactivity. We hypothesized that an attenuated cortisol awakening response would be associated with developmental and behavioral problems at school age in EPT c...

Importance: Intravitreal bevacizumab effectively treats severe retinopathy of prematurity (ROP), but it enters the bloodstream and may reduce serum vascular endothelial growth factor (VEGF), potentially causing detrimental effects on developing organs in the premature infant. Objective: To evaluate the association of intravitreal bevacizumab wit...

Importance: Cataract is an important cause of visual impairment in children. Data from a large pediatric cataract surgery registry can provide real-world estimates of visual outcomes and the 5-year cumulative incidence of adverse events. Objective: To assess visual acuity (VA), incidence of complications and additional eye operations, and refrac...

Background Application of current retinopathy of prematurity (ROP) screening criteria results in many unnecessary examinations, because only 5%-10% of infants screened require treatment. Application of screening criteria established by the Postnatal Growth and Retinopathy of Prematurity Study could significantly reduce unnecessary examinations with...

Background As instrument-based pediatric vision screening technology has evolved, the American Association for Pediatric Ophthalmolgy and Strabismus (AAPOS) has developed uniform guidelines (2003, updated 2013) to inform the development of devices that can detect specified target levels of amblyopia risk factors (ARFs) and visually significant refr...

Premature infants with severe retinopathy of prematurity (ROP) are often treated using anti–vascular endothelial growth factor drugs such as bevacizumab. Intravitreal bevacizumab reaches the systemic circulation and is associated with reduced serum vascular endothelial growth factor levels in premature infants.¹ Vascular endothelial growth factor i...

This study evaluates the 24-month follow-up for the NICHD Neonatal Research Network (NRN) Inositol for Retinopathy Trial. Bayley Scales of Infants Development-III and a standardized neurosensory examination were performed in infants enrolled in the main trial. Moderate/severe NDI was defined as BSID-III Cognitive or Motor composite score <85, moder...

Importance Both preterm birth and increased screen time are known to be associated with an increase in risk of developmental and behavioral sequelae. The association between high screen time or a television or computer in the bedroom in early school age and adverse cognitive, executive function, language, and behavior outcomes of extremely preterm...

Purpose: To describe characteristics and outcomes of patients with retinopathy of prematurity (ROP) who failed intravitreal anti-VEGF. Methods: A retrospective case series of 211 eyes (112 patients) treated with anti-VEGF as initial therapy for ROP at a single academic institution between 2011-2019, and an additional 6 eyes (3 patients) referred...

Importance Intravitreous bevacizumab (0.25 mg to 0.625 mg) is commonly used to treat type 1 retinopathy of prematurity (ROP), but there are concerns about systemic toxicity, particularly the risk of neurodevelopmental delay. A much lower dose may be effective for ROP while reducing systemic risk. Previously, after testing doses of 0.25 mg to 0.031...

Purpose The purpose of this assessment is to evaluate the accuracy of autorefraction compared with cycloplegic retinoscopy in children. Methods Literature searches were last conducted in October 2019 in the PubMed and the Cochrane Library databases for studies published in English. The combined searches yielded 118 citations, of which 53 were revi...

The Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study showed that the addition of postnatal weight gain to birth weight and gestational age detects similar numbers of infants with ROP, but requires examination of fewer infants. To determine the incremental cost-effectiveness of screening with G-ROP compared with conventional screening....

We report a case of stretched scar syndrome in a 12-year-old girl with consecutive exotropia who had previously been treated with bilateral medial rectus muscle recessions. Stretched scar syndrome was confirmed intraoperatively, and bilateral medial rectus muscle plication was performed, successfully restoring normal alignment. Use of plication rat...

Purpose: To review the published literature assessing the efficacy of binocular therapy for the treatment of amblyopia compared with standard treatments. Methods: Literature searches with no date restrictions and limited to the English language were conducted in January 2018 and updated in April 2019 in the PubMed database and the Cochrane Libra...

Purpose: To compare the visual outcomes and adverse events associated with optical correction using an intraocular lens (IOL), contact lenses, or spectacles after cataract surgery in children 2 years of age or younger. Methods: Literature searches were conducted in PubMed, the Cochrane Library, and the databases of clinical trials in February 20...

Objective: Medium- and long-term sequelae of intravitreal bevacizumab (IVB) for type 1 retinopathy of prematurity (ROP) are uncertain. Our aim was to describe the fluorescein angiography (FA) findings in patients who received IVB as primary treatment for type 1 ROP and compare them to findings in patients with ROP that spontaneously regressed. De...

Objective: To review the published evidence to evaluate the ability of orthokeratology (Ortho-K) treatment to reduce myopic progression in children and adolescents compared with the use of spectacles or daytime contact lenses for standard refractive correction. Methods: Literature searches of the PubMed database, the Cochrane Library, and the da...

Importance Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its efficacy or safety. Objective To test the adverse events and efficacy of myo-inositol to reduce t...

Objective: To investigate associations in toddlers born extremely preterm (<28 weeks) between neonatal neuroimaging and 18- to 22-month developmental and behavioral outcomes. Study design: Cohort analysis from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network Surfactant Positive Airway...

The Multicenter Trial of Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) was a pioneering study that not only proved that ablative therapy could prevent the late and blinding cicatricial stages of ROP, but also elucidated its natural history.¹ As the first study of its kind to apply the newly defined International Classification for ROP to ga...

Objective: To review the published literature assessing the efficacy of beta-blockers for the treatment of periocular hemangioma in infants. Methods: Literature searches were conducted in May 2018 in PubMed with no date restrictions and limited to studies published in English and in the Cochrane Library database without any restrictions. The com...

Purpose: To evaluate an alternative retinopathy of prematurity (ROP) screening system that identifies infants meriting examination by an ophthalmologist in a middle-income country. Methods: The authors hypothesized that grading posterior pole images for the presence of pre-plus or plus disease has high sensitivity to identify infants with type 1...

Objective: To identify rates of overweight (body mass index [BMI] ≥85th percentile) and obesity (BMI ≥95th percentile) at 6-7 years of age and associated risk factors among extremely preterm infants born at <28 weeks of gestation. Study design: Anthropometrics, blood pressure, and active and sedentary activity levels were prospectively assessed....

Purpose: To review the published literature to assess the visual outcomes and adverse events associated with the 2 most commonly used contact lenses for treating aphakia in children: silicone elastomer (SE) and rigid gas permeable (RGP). Methods: Literature searches were last conducted in January 2018 in the PubMed, Cochrane Library, and Clinica...

Purpose To evaluate (1) the feasibility of nonophthalmologist healthcare workers (HCWs) obtaining images of sufficient quality for retinopathy of prematurity (ROP) screening using a Food and Drug Administration-approved portable, noncontact, narrow-field fundus camera (i.e., Pictor; Volk Optical, Inc, Mentor, OH) and (2) the accuracy of grading the...

Purpose To review the published literature on the efficacy of topical atropine for the prevention of myopic progression in children. Methods Literature searches were last conducted in December 2016 in the PubMed database with no date restrictions, but were limited to studies published in English, and in the Cochrane Library database without any re...

Importance Intravitreous bevacizumab (0.25 to 0.625 mg) is increasingly used to treat type 1 retinopathy of prematurity (ROP), but there remain concerns about systemic toxicity. A much lower dose may be effective while reducing systemic risk. Objective To find a dose of intravitreous bevacizumab that was lower than previously used for severe ROP,...

Objective: To characterize actual achieved patterns of oxygenation in infants born appropriate vs small for gestational age (SGA) randomized to a lower (85-89%) vs higher (91%-95%) oxygen saturation target in the Surfactant Positive Pressure and Oxygen Trial. To determine the association between achieved oxygen saturation levels and survival in in...

Purpose: To review the available evidence on the ocular safety and efficacy of anti-vascular endothelial growth factor (VEGF) agents for the treatment of retinopathy of prematurity (ROP) compared with laser photocoagulation therapy. Methods: A literature search of the PubMed and Cochrane Library databases was conducted last on September 6, 2016,...

Purpose: The Handy Eye Chart™ is designed to assist in evaluating the visual acuity of patients with non-standard communication styles. The Handy Eye Chart™ has been previously validated against the early treatment diabetic retinopathy study (ETDRS) chart. The aim of this research is to compare visual acuity outcomes with The Handy Eye Chart™ agai...

PurposeFive-year prospective data on children enrolled in the Infant Aphakia Treatment Study (IATS) provided an opportunity to explore ocular and systemic associations in patients with a unilateral congenital cataract.Methods Infants <7 months of age with a unilateral cataract were eligible for IATS screening. We reviewed data pertaining to the exc...

Purpose To compare the results of visual acuity testing in a population of deaf children using the Handy Eye Chart versus the Lea Symbols Chart and to compare testability and preference between charts. Methods A total of 24 participants were recruited at the Atlanta Area School for the Deaf. Visual Acuity was evaluated using the Handy Eye Chart an...

Objective: To assess the accuracy with which available retinopathy of prematurity (ROP) predictive models detect clinically significant ROP and to what extent and at what risk these models allow for the reduction of screening examinations for ROP. Methods: A literature search of the PubMed and Cochrane Library databases was conducted last on May...

Significant advancements in vision screening research are leading to improved design, functionality, and reliability of screening tools. Presently, two vision screening approaches are available to school nurses for children ages 3 years and older: optotype-based screening and instrument-based screening. Optotype-based screening pertains to tests of...

To determine the relative effectiveness, major complications, and refractive errors associated with intravitreal bevacizumab (IVB) versus panretinal photocoagulation (PRP) to treat type 1 retinopathy of prematurity (ROP). Retrospective case series. Consecutive infants with type 1 ROP who received either IVB or PRP and had at least 6 months of follo...

Purpose. To recommend a standardized approach for measuring progress toward national goals to improve preschool children's eye health. Methods. A multidisciplinary panel of experts reviewed existing measures and national vision-related goals during a series of face-to-face meetings and conference calls. The panel used a consensus process, informed...

Purpose. This article provides a rationale for developing an integrated data system for recording vision screening and eye care follow-up outcomes in preschool-aged children. The recommendations were developed by the National Expert Panel to the National Center for Children's Vision and Eye Health at Prevent Blindness and funded by the Maternal and...

Purpose. This article provides recommendations for screening children aged 36 to younger than 72 months for eye and visual system disorders. The recommendations were developed by the National Expert Panel to the National Center for Children's Vision and Eye Health, sponsored by Prevent Blindness, and funded by the Maternal and Child Health Bureau o...

Purpose To establish objective lower limits of normal optic nerve (ON) size in children based on high-resolution orbital magnetic resonance imaging (MRI). Design Case control study of patients with ON hypoplasia vs. normal controls. Methods A neuroradiologist made four measurements of each ON at two locations (5 mm posterior to the optic disc and...

Abducens nerve palsy is the most common acquired ocular motor nerve palsy in adults. Chronic cases of abducens palsy often require surgical intervention to relieve disabling diplopia. The goal of this study was to identify factors associated with surgical outcomes in isolated abducens palsy. Medical records of all adult patients from 1988 to 2012 w...

Strabismus from third nerve palsy (3NP) is difficult to treat. Our goal was to explore factors associated with successful surgical outcomes in 3NP. Institutional records of all adult patients (>18 years) from 1988 to 2012 with 3NP who underwent strabismus surgery or botulinum toxin injections were retrospectively reviewed. Success was defined as ab...

Purpose To compare the costs of diagnostic work-up for optic disk drusen where ophthalmic ultrasound was performed prior to imaging and invasive studies with those where ophthalmic ultrasound was performed after such studies. Methods The medical records of patients <18 years of age evaluated at a tertiary referral center between 2007 and 2012 for...

Purpose To compare visual acuity results obtained with the Handy Eye Chart to results obtained using the Handy Eye Check, a mobile medical application that electronically presents isolated Handy Eye Chart optotypes according the Amblyopia Treatment Study (ATS) protocol. Methods Consecutive patients 6-18 years of age presenting for eye examinations...

Objective: To investigate the outcomes of strabismus surgery in patients with a prior history of a scleral buckling procedure for retinal reattachment. Methods: We reviewed the medical records of 18 patients who underwent strabismus surgery following a scleral buckling procedure and investigated the effect of multiple variables on postoperative...

We report 3 patients who were delivered prematurely and who developed a lens opacity with signs of ocular inflammation at a postgestational age of 10-52 weeks. All patients had been treated for Candida sepsis as neonates. Each patient underwent lensectomy and anterior vitrectomy. In 2 infants Candida albicans was cultured from the lens/anterior cha...

Introduction Refractive surgery has the potential to be a definitive treatment for accommodative esotropia, yet it has not been widely embraced. This article reviews the current literature on refractive surgery to treat accommodative esotropia. Methods A literature search was performed using the following terms: refractive surgery, photorefractive...

Horizontal strabismus due to a weak rectus muscle can be treated with an augmented Hummelsheim procedure, in which both vertical rectus muscle tendons are split, resected by 4 mm, and reattached to the sclera adjacent to the weak rectus muscle. Compared with vertical rectus transposition, the procedure spares two ciliary vessels and does not requir...

OBJECTIVES: To assess WINROP (https://winrop.com), an algorithm using postnatal weight measurements, as a tool for the prediction of retinopathy of prematurity (ROP) in a large geographically and racially diverse study population. METHODS: WINROP analysis was performed retrospectively on conventionally at-risk infants from 10 neonatal intensive car...

To design a simple matching acuity test based on hand gestures that is minimally dependent on familiarity with symbols and letters. The visual acuity results obtained from children using the Handy Eye Chart were compared with results obtained with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Evaluation of diagnostic test or technol...

Objective: To determine how often nasolacrimal duct obstruction (NLDO) resolves with 6 months of nonsurgical management in infants aged 6 to less than 10 months. Methods: As part of a randomized trial evaluating the cost-effectiveness of immediate office probing vs observation with deferred probing for unresolved cases, 107 infants aged 6 to less t...

Objective: To assess current practices, attitudes, and perceived barriers toward pediatric vision screening. Patients and Methods: A link to a 9-question survey was electronically distributed to a national sample of 6000 pediatricians through Medical Marketing Services Inc. Data were collected using Survey Monkey. Results: Email open rate was 11%;...

To assess whether outcomes of strabismus surgery are improved by using the adjustable suture technique and to determine which subgroups of strabismus patients benefit most from the adjustable suture technique. A retrospective chart review. A total of 535 adults who underwent strabismus surgery between 1989 and 2010. Success was defined as ≤10 prism...

To determine the validity and reliability of a novel questionnaire to measure vision-related quality of life (VRQOL) in children ages 8-18 years for use in juvenile idiopathic arthritis (JIA)-associated uveitis: the Effects of Youngsters' Eyesight on Quality of Life (EYE-Q). Several steps validated the EYE-Q. We interviewed experts and children on...

Reducing visual impairment and blindness in children in resource-poor countries is one of the key components of the major global prevention of blindness initiative, VISION 2020 the Right to Sight. Although visual impairment and blindness among children is much less common than among adults, the potential lifespan of a child means that the lifelong...

To determine whether measurements obtained by partial coherence interferometry (PCI) correlate well with measurements obtained using immersion ultrasound (US) in children. Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA. Evaluation of a diagnostic test or technology. The charts of pediatric patients who had c...

To evaluate the preferences of pediatric ophthalmologists and vitreoretinal surgeons with regard to the initial management of scleral perforation during strabismus surgery and to determine whether they perceived one mode of treatment conferred a significant advantage over another in terms of the complication rate. Six hundred sixty-five pediatric o...

To report the long term outcomes of photorefractive keratectomy (PRK) for the treatment of hyperopia associated with purely refractive accommodative esotropia. This study was a retrospective chart review of 40 patients aged 17-39 years who underwent PRK to eliminate their dependence on glasses. Pre- and postoperative best spectacle corrected visual...

Extraocular muscle surgery is performed to correct strabismus. Strabismus includes any horizontal, vertical, or torsional misalignment of the eyes and can affect either children or adults. The disease can be categorized as congenital, acquired, restrictive, or paralytic. The goal of surgery is to restore the eyes to their normal anatomical position...

To report the outcomes after cataract extraction in eyes previously treated for retinoblastoma. We reviewed the medical records of consecutive patients treated with cataract extraction at our institution for radiation-induced cataract following retinoblastoma treatment between 1992 and 2007. Twelve eyes of 11 patients were included. The median age...

To determine the value of serial personal photographs in timing the onset of unilateral cataracts in children over 6 months of age. Personal photographs from children with unilateral cataracts who underwent cataract extraction and intraocular lens implantation when > or =6 months of age were reviewed. Photographs were evaluated for changes in the r...

To summarize the evolution of the treatment of pediatric refractive errors, with an emphasis on recent advancements in the use of refractive surgery to treat children. Literature review. We searched MEDLINE (1950 through October 2007), the Cochrane library (December through October 2007), and the Cumulative Index for Nursing and Allied Health Liter...

• Most traumatic corneal abrasions should not be patched. Topical non-steroidal anti-inflammatory drugs are helpful in reducing the associated pain. • Children with sickle cell hemoglobinopathy are at greater risk of developing optic nerve ischemia and secondary hemorrhages with traumatic hyphemas. • Vitreous hemorrhages in children can cause ambly...

To describe the characteristics of eyes with late vitreous hemorrhage in children with a history of regressed retinopathy of prematurity (ROP). The medical records of consecutive patients with regressed ROP presenting to our institution with late vitreous hemorrhage between 1995 and 2006 were reviewed. Thirteen patients (14 eyes) were identified. A...

Purpose: To describe the characteristics of eyes with late vitreous hemorrhage in children with a history of regressed retinopathy of prematurity (ROP). Methods: The medical records of consecutive patients with regressed ROP presenting to our institution with late vitreous hemorrhage between 1995 and 2006 were reviewed. Results: Thirteen patients (...

An association between morning glory disk anomaly (MGDA) and intracranial vascular anomalies including Moyamoya disease has been recognized. We evaluated a series of patients with MGDA to ascertain the frequency of cerebrovascular anomalies. Retrospective observational case series. We reviewed the neurologic histories and neuroimaging studies of tw...

Eye muscle surgery is performed to correct strabismus, which is any horizontal, vertical, or torsional misalignment of the eyes that affects both children and adults. The disease can be congenital, acquired, restrictive, or paralytic. The purpose of surgery is to restore the eyes to their normal, anatomical position; to maximize the potential for b...

Many children with accommodative esotropia are able to successfully discontinue spectacle wear, while others require spectacle correction into adulthood. Parents often ask about the likelihood of glasses being required on a long-term basis and whether use of spectacles will cause dependency. Most infants are hyperopic and gradually become emmetropi...

This is the third article in a series on the various facets of the management of strabismus in adults. Here, we give a broad overview of the types and severity of disability and provide initial validation of an instrument (questionnaire) to assess these disability aspects. After undergoing strabismus surgery, 101 patients from 6 centers completed a...

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