Göran Darius Hildebrand

Göran Darius Hildebrand
Oxford University Hospitals NHS Trust | OUH NHS · Oxford Eye Hospital

BM BCH (Oxon) MPhil (Cantab) MD (Dartmouth) DCH (Lond) FEBO FRCS (Edin) FRCOphth (Lond)

About

66
Publications
5,138
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462
Citations
Introduction
Göran Darius Hildebrand is a Consultant Ophthalmic Surgeon at the Oxford University Hospitals NHS Foundation Trust where he leads the Paediatric Ophthalmology Service. He is Senior Examiner and Committee Member of the European Board of Ophthalmology Fellowship Exam in Strabismus and Paediatric Ophthalmology and President of the European Paediatric Ophthalmology Society since 2017.

Publications

Publications (66)
Article
Background: Donnai Barrow Syndrome (DBS) is a rare, multi-system autosomal recessively inherited disorder of relevance to ophthalmologists. To aim to describe the ocular phenotype using multimodal imaging for two cases of genetically confirmed DBS and compare against the published phenotype. Materials and methods: Retrospective case series of tw...
Article
Background Subluxation of the crystalline lens in childhood confronts the surgeon with a dilemma: to operate or to wait and see. Surgery is usually not performed when the subluxation is still limited. However, postponing the surgery increases the surgical difficulty as the capsular bag becomes more difficult to use as a means of support for the int...
Article
Infantile haemangiomas (IHs) are the most common benign tumours of the eyelid and orbits in infancy. Beta-blockers, in the form of oral propranolol, have become first-line treatment in severe cases with functionally significant or disfiguring IH. However, adverse drug reactions of oral propranolol in infants are reported in 1 in 11 and serious or p...
Article
Full-text available
Infantile hemangiomas are common benign vascular tumors but are rarely found in an intracranial location. Our literature review identified 41 reported cases. There is no general consensus on management of these rare lesions and until recently, treatment was limited to surgery or pharmacological management with steroids or interferon. Although beta-...
Article
Purpose To investigate the presence of peer bias directed at young children aged 3-6 years of age and the age at which this bias emerges. Methods Children (3-6 years) completed an individual testing session involving two tasks: (1) a paired photograph task examined the effect of the appearance of ptosis on children’s preferences in two different s...
Article
In recent years, an increasing incidence of laser pointer-associated retinal injuries has been observed, likely due to easy access to incorrectly classified laser pointers, their labelling as toys, and lack of awareness concerning the associated risk. Laser pointer exposure can lead to irreversible retinal damage and associated vision loss, dependi...
Article
Full-text available
Nodular fasciitis (NF) is a subcutaneous, nodular, pseudo-sarcomatous, fibroblastic proliferation. It is rarely reported in the periorbital region and the management approach is variable. Presented is an eight-year-old female with a three month history of a periorbital mass. Incisional biopsy histologically confirmed nodular fasciitis with a unique...
Article
Vision loss is a known rare complication of prone positioning during surgery. Vision loss following prone surgery is most commonly attributed to direct pressure on the eye but can also be caused by central retinal artery occlusion (CRAO) in the absence of pressure on the eye. Central retinal artery occlusion has not been previously described follow...
Article
A newborn boy with genetically confirmed Wolf-Hirschhorn syndrome presented with severe bilateral corneal ulceration that required emergency surgical tarsorrhaphies and permanent lower punctal occlusion. The patient healed completely, with no recurrence over 18 months of follow-up.
Article
Purpose: To assess whether near infrared autofluorescence (NIR-AF) imaging is a useful imaging modality in the diagnosis of handheld laser retinal injuries. Design: Retrospective observational case series. Methods: 12 patients identified to have handheld laser retinal injuries were included at two academic centers. Patients underwent ophthalmi...
Article
Infantile haemangioma is a relatively common benign tumour which often does not require treatment. We present a case of a segmental infantile haemangioma with periocular involvement impacting on early visual development which was successfully treated with topical timolol maleate 0.5% drops in the developing world.
Article
Full-text available
Handheld laser devices are easily available to purchase through the internet and unregulated marketplaces at a relatively low cost. They are particularly attractive to children as they are seen as ‘high tech', brightly coloured, and known to be able to burn holes in objects such as balloons. There is a widespread lack of knowledge about the risks o...
Article
Möbius syndrome is a neurological disorder involving underdevelopment of the sixth and seventh cranial nerves. Multiple associations have been described including dysfunction of other cranial nerves, limb abnormalities and hypogonadotrophic hypogonadism causing delayed puberty. We present the second reported case of Möbius syndrome associated with...
Article
Full-text available
Background: Infantile capillary hemangiomas (IHs) affect approximately 4-5% of infants. The systemic nonselective β-adrenergic antagonist, propranolol, has become the standard first-line treatment for severe IHs. The topical β-antagonist, timolol maleate, has also demonstrated efficacy and safety in treating superficial and some deep capillary hem...
Article
Full-text available
Retropupillary fixation of the Artisan iris claw lens (Ophtec, Groningen, Netherlands) has been shown to be a very useful option in the setting of intraocular lens (IOL) implantation where capsular support is lacking, and giving good visual and refractive outcomes in children (1).
Article
Sickle cell orbitopathy is a rare manifestation of a sickle cell crisis and can closely mimic orbital cellulitis, both clinically and radiologically. We present a case where a child presented with what was thought to be orbital cellulitis and was treated accordingly. Subtle radiologic features of sickle cell orbitopathy were initially overlooked, r...
Article
A 2-year-old girl presented with a 2-month history of episodic segmental ovalization of the right pupil, each occurrence following waking up from sleep (Figure 1A). The tadpole pupil would begin to improve after 10 minutes (Figure 1B) and completely resolve after 40 minutes (Figure 1C). She had a history of partial right-sided ptosis at birth with...
Article
Full-text available
Background Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris. Case presentation An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastati...
Article
This retrospective, consecutive, clinical case series examined the use of topical timolol in the treatment of 5 children with deep, periocular infantile hemangiomas that caused astigmatism, change in head posture, or ptosis. All patients were treated with timolol maleate solution 0.5% twice daily until the lesions had regressed. All 5 children show...
Article
The treatment of infantile hemangiomas changed from the use of oral corticosteroids to oral propranolol upon the serendipitous discovery of propanolol's clinical effectiveness in 2008. Since then, clinicians have begun to use topical beta blockers, in particular, timolol maleate 0.5% gel forming solution, with good effect. Topical beta blockers are...
Article
Retinopathy of prematurity (ROP) is a leading cause of visual loss in infancy that is largely preventable with careful screening. We report the safety and efficacy of the use of phenylephrine 2.5% and cyclopentolate 0.5% eyedrops instilled 3 times 5 minutes apart in ROP screening. A total of 1246 ROP screening eye examinations were carried out by t...
Article
We describe a novel and simple technique for temporary lid closure in severe bilateral corneal exposure keratopathy, where a rapid method for corneal protection is required. The aim is to create a stable dressing base for secure closure of the eyelids that also allows instillation of medication and examination of the eye. Copyright © 2014 American...
Article
To the Editor: Byrd et al. (July 4 issue)(1) describe the beneficial targeting of Bruton's tyrosine kinase (BTK) with ibrutinib in relapsed chronic lymphocytic leukemia (CLL), and we note the absence of any visual deterioration in the cohort. We herein report on an 80-year-old woman with CLL who had received ibrutinib for the preceding 6 months and...
Article
Children treated for toxoplasma retinochoroiditis may experience a range of severe adverse drug responses. Drug reaction with eosinophilia and systemic symptoms syndrome is a life-threatening idiosyncratic drug reaction with a 10% mortality. We present a case of drug reaction with eosinophilia and systemic symptoms syndrome in a child on standard c...
Article
Visual rehabilitation of children with penetrating eye injuries often carries a poor prognosis. When capsular support is insufficient, implantation of the aphakic Artisan (Ophtec, The Netherlands) iris-claw intraocular lens (IOL) in front of the iris is an accepted alternative to anterior chamber or scleral-fixated implantation. With anterior chamb...
Article
Full-text available
Oral propranolol hydrochloride is widely used as first-line therapy for periocular infantile capillary hemangiomas. Close monitoring is required as potentially serious adverse effects are well recognized. Recently, the topical β-antagonist timolol maleate has also been reported to be an effective treatment for superficial infantile hemangiomas (IHs...
Article
Pyridoxine-dependent epilepsy (PDE) is a cause of neonatal epileptic encephalopathy not previously known to cause ophthalmic disease. We describe the novel observation of a 5-year-old girl with pyridoxine-dependent epilepsy and bilateral cataracts. PDE is the result of mutations in the ALDH7A1 gene encoding antiquitin, an enzyme protective against...
Article
With the advent of confocal microscopy and optical coherence tomography, high-resolution multimodal imaging of the retina and optic nerve head can now be obtained routinely, providing new diagnostic clues in a variety of neuro-ophthalmological conditions. In this review, we provide an overview of these imaging advances and their clinical applicatio...
Article
We read with great interest the recent article ‘Efficacy of systemic propranolol for severe infantile haemangioma of the orbit and eyelid: a case study of eight patients’, advocating oral propranolol as first-line therapy for periocular capillary haemangiomas.1 We would like to add topical timolol to the available treatment options, which was not m...
Article
Full-text available
The authors report a case of second degree heart block associated with topical latanoprost treatment. The authors discuss the possibility of a causative effect as the cessation of this treatment resulted in improvement of the arrhythmia. The authors highlight previous reports and research in humans and animals which demonstrate an association of ar...
Article
Oculopharyngeal muscular dystrophy is a neuromuscular disease usually presenting in the 5th or 6th decades of life with a dominant inheritance pattern. In almost all cases the cause of the disease is the expansion of a DNA repeat sequence containing GCG and GCA codons in exon 1 of the PABPN1 gene from 10 to between 12 and 17 repeats. However one ca...
Chapter
The retina remains the best studied part of the human brain. Embryologically part of the central nervous system [1–5], but readily accessible to examination, it can be investigated with relative ease by both scientists and clinicians. Moreover, an estimated 80% of all sensory information in humans is thought to be of retinal origin [6], indicating...
Article
We report a 4-year-old child with severe semi-lobar holoprosencephaly (HPE) not expected to survive after birth. Magnetic resonance imaging (MRI) revealed agenesis of the corpus callosum, absence of the third ventricle, fused thalami and basal ganglia. To investigate sensory function, visual, auditory and somatosensory evoked potential and imaging...
Article
Neonatal herpetic infection is uncommon, with an estimated incidence of 1 in 3000 to 20,000 births. Ocular involvement most commonly consists of blepharoconjunctivitis or keratitis. We present a further manifestation of congenital herpes simplex virus (HSV) 2 infection.
Article
Purpose: To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis. Methods: Interventional case report. Results: A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed in...
Article
To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis. Interventional case report. A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed infective meningoencephalitis, she...
Article
Pretreatment laboratory values (followed by reference ranges) includedthe following: white blood cells, 9.9 × 10³/µL (5.0-15.0× 10³/µL); lymphocytes, 6.5 × 10³/µL(2.0-9.5 × 10³/µL); monocytes, 0.7 × 10³/µL (0.3-1.5 × 10³/µL); eosinophils, 0.2× 10³/µL (0.3-0.8 × 10³/µL);basophils, 0.1 × 10³/µL (0-0.2 × 10³/µL);red blood cells, 5.0 × 10⁶/µL (3.7-5.3...
Article
To determine the efficacy of anterior chamber decompression in the management of intraocular pressure (IOP) spikes in the early period after uneventful phacoemulsification. Royal Free Hospital, Department of Ophthalmology, Royal Free and University College London Medical School, London, United Kingdom. This prospective case series comprised 11 cons...
Article
To compare the incidence and the spectrum of postoperative complications detected when the intraocular pressure (IOP) is reviewed 4 to 6 hours or the day after uneventful phacoemulsification cataract extraction and intraocular lens (IOL) implantation. Royal Free Hospital, London, United Kingdom. The study cohort consisted of 141 patients who had un...
Article
After an extensive review of the literature, we believe this to be the first case description of the removal of a simple testicular cyst from an infant. The 1 1/2-month-old infant was admitted to the Department of Pediatric Surgery after the mother had noticed a swelling in the right testicle. The tentative clinical diagnosis by ultrasound was a cy...
Article
We have examined two T lymphocyte cell surface molecules, CD4 and CD7, as targets for specific delivery of drugs from antibody-directed liposomes. The efficiency of uptake by peripheral lymphocytes, thymocytes, and two CEM sublines (CEM.MRS and CEM-T4) of anti-CD4 and anti-CD7 liposomes containing methotrexate was evaluated by the methotrexate-medi...

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