Scott R Lambert

• Emory University

Parts of material previously presented at Annual Meetings of the Association for Research in Vision and Ophthalmology and the American Association of Pediatric Ophthalmology and Strabismus. Trial Registration: ClinicalTrials.gov Identifier: NCT00212134.

Background: Amblyopia is the most common cause of vision loss in children. Amblyopia has been associated with impaired depth perception but little attention has been paid to the extent to which amblyopia increases the risk of obesity. Methods: Public-use data from the 1999-2008 National Health and Nutrition Examination Survey were used. Analyses we...

Purpose: With the expansion of neonatal care in sub-Saharan Africa (SSA), an increasing number of premature babies are at risk to develop retinopathy of prematurity (ROP). Previous studies have quantified the cost-effectiveness of addressing ROP in middle-income countries, but few have focused on SSA. This study estimates the cost of a national pr...

Background To address the threat of retinopathy of prematurity (ROP) in Sub-Saharan Africa (SSA), the Stop Infant Blindness in Africa (SIBA) project introduced a comprehensive program, including subspecialty training and oxygen management equipment. Methods A before-and-after retrospective cohort study compared preterm infants < 1750 g or < 34 wee...

Background: To address the threat of retinopathy of prematurity (ROP) in Sub-Saharan Africa (SSA), the Stop Infant Blindness in Africa (SIBA) project introduced a comprehensive program, including subspecialty training and oxygen management equipment. Methods: A before-and-after retrospective cohort study compared preterm infants <1750g or <34 weeks...

Importance Parents may be concerned about the adverse outcomes of occlusion therapy in children treated for unilateral congenital cataract (UCC). Objective To determine whether occlusion therapy in children treated for UCC with poor visual outcomes is negatively associated with poorer child and/or family functioning. Design, Setting, and Particip...

Well-known risk factors for anterior segment ischemia (ASI) following strabismus surgery include ipsilateral surgery on three or more rectus muscles, older age, and vasculopathy. ASI is rarely reported in young patients following uneventful strabismus surgery on two ipsilateral rectus muscles. We report a 30-year-old transgender female on long-term...

Purpose: To investigate causes of childhood blindness in the United States using the IRIS® Registry (Intelligent Research in Sight). Design: Cross-Sectional Study. Participants: Patients ≤18 years of age with visual acuity 20/200 or worse in their better seeing eye in the IRIS Registry during 2018. Methods: Causes of blindness were classifie...

Retinopathy of prematurity (ROP) is a leading cause of childhood blindness. Not only do the epidemiologic determinants and distributions of patients with ROP vary worldwide, but clinical differences have also been described. The Third Edition of the International Classification of ROP (ICROP3) acknowledges that aggressive ROP (AROP) can occur in la...

Purpose: To determine the cumulative incidence of strabismus surgery after pediatric cataract surgery and identify the associated risk factors. Design: US population-based insurance claims retrospective cohort study. Participants: Patients ≤ 18 years old who underwent cataract surgery in 2 large databases: Optum Clinformatics Data Mart (2003–2021)...

Purpose To determine the relative contribution of intraocular lens (IOL) calculation accuracy and ocular growth variability to the long-term refractive error predicted following pediatric cataract surgery. Methods Pseudophakic eyes of children enrolled in the Infant Aphakia Treatment Study (IATS) were included in this study. Initial absolute predi...

Purpose To correlate the diagnosis of glaucoma among children in the Infant Aphakia Treatment Study (IATS) by age 10 years with anterior segment optical coherence tomography (AS-OCT) findings. Methods A multicenter randomized controlled trial of 114 infants with unilateral congenital cataract who were 1-6 months of age at surgery. Data on long-ter...

Pediatric chronic noninfectious uveitis (NIU) can lead to sight-threatening complications and often requires long-term immunosuppression. Uveitis occurs in isolation (ie, idiopathic NIU), or is associated with systemic diseases, most commonly juvenile idiopathic arthritis (JIA).

Objective To compare the rate of refractive growth (RRG3) of the crystalline lens (“lens”) versus the eye excluding the lens (“globe”) for the fellow, noncataractous eyes of participants in the Infant Aphakia Treatment Study. Design Retrospective cohort study. Subjects A total of 114 children who had unilateral cataract surgery as infants were re...

Purpose To characterize long-term strabismus outcomes in children in the Infant Aphakia Treatment Study (IATS). Methods This study was a secondary data analysis of long-term ocular alignment characteristics of children aged 10.5 years who had previously been enrolled in a randomized clinical trial evaluating aphakic management after unilateral cat...

Purpose: To determine the cumulative incidence of retinal detachment (RD) repair following pediatric cataract surgery and identify the associated risk factors. Design: US population-based insurance claims retrospective cohort study. Participants: Patients ≤ 18 years old who underwent cataract surgery in 2 large databases: Optum Clinformatics (...

Background The refraction prediction error (PE) for infants with intraocular lens (IOL) implantation is large, possibly related to an effective lens position (ELP) that is different than in adult eyes. If these eyes still have nonadult ELPs as they age, this could result in persistently large PE. We aimed to determine whether ELP or biometry at age...

Background: Traumatic brain injury (TBI) is one of the common causes of ocular motor nerve (oculomotor nerve [CN3], trochlear nerve [CN4], and abducens nerve [CN6]) palsies, but there has been no large study of ocular motor nerve palsy caused by TBI. This study aimed to investigate the characteristics of and differences in ocular motor nerve palsy...

Objective Pediatric uveitis can lead to sight‐threatening complications and can impact quality of life (QoL) and functioning. We aimed to examine health‐related QoL, mental health, physical disability, vision‐related functioning (VRF), and vision‐related QoL in children with juvenile idiopathic arthritis (JIA), JIA‐associated uveitis (JIA‐U), and o...

We used population-based data obtained from Optum’s Clinformatics® Data Mart Database to characterize recent trends in retinopathy of prematurity (ROP) treatments and outcomes in the United States. Laser photocoagulation was utilized more frequently every year compared to anti-VEGF.

Refraction predictions from intraocular lens (IOL) calculation formulae are inaccurate in children. We sought to quantify the relationship between age and prediction error using a model derived from the biometry measurements of children enrolled in the Infant Aphakia Treatment Study (IATS) when they were ≤7 months of age. We calculated theoretical...

We studied the myopic shift and anisometropia at 10.6 (+/-0.3) years of age in the Infant Aphakia Treatment Study. We found myopic shift continues in the operated eye from 5-10.5 years at a lower rate than that prior to age five years while anisometropia increases proportionally. The Infant Aphakia Treatment Study (IATS) is a randomized clinical tr...

A total of 167 cases (0.111%) of infectious complications (endophthalmitis, orbital cellulitis, preseptal cellulitis, and postoperative infection) were identified in patients after strabismus surgery. The incidence of postoperative endophthalmitis was approximately 1 per 13,700 strabismus surgeries (0.007%) among 151,011 strabismus surgeries in US...

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...

Objective The Effects of Youngsters’ Eyesight on Quality of Life (EYE‐Q) questionnaire measures vision‐related functioning (VRF) and vision‐related quality of life (VRQoL) in children with uveitis. Our aim was to revise the alpha version of the EYE‐Q to refine VRF and VRQoL subscales and to assess the validity of the EYE‐Q. Methods Children with j...

Background Delayed treatment of congenital or infantile cataracts can cause deprivation amblyopia. Prompt diagnosis and surgical intervention is critical for optimal outcomes. This study assessed referral patterns for congenital or infantile cataracts in two regions of the United States. Methods The medical records of children 0-1 years of age wit...

Purpose To examine risk factors for strabismus surgery reoperation in patients with thyroid eye disease (TED). Design Retrospective cohort study Methods An insurance claims database was used to identify patients with TED who underwent at least one strabismus operation between 2003 and 2019. We recorded specific muscles operated on, as well as the...

Purpose: To investigate types of surgeries performed to treat a presumed congenital superior oblique palsy (SOP) and the reoperation rate. Methods: This was a population-based retrospective cohort study using claims data from the United States. Patients who underwent strabismus surgery for a presumed congenital SOP with ≥ 3 months of continuous...

Purpose To review the scientific literature that evaluates the effectiveness of adjustable sutures in the management of strabismus for adult and pediatric patients. Methods Literature searches were performed in the PubMed database through April 2021 with no date limitations and were restricted to publications in English. The searches identified 55...

Purpose To determine the rate of superior oblique surgery and how often it is combined with surgery on other extraocular muscles or associated with subsequent strabismus surgeries in children and young adults with Brown syndrome. Methods This was a population-based retrospective cohort study using the Optum deidentified Clinformatics Data Mart Dat...

Purpose: The aim of this study was to assess the effect of corneal crosslinking on vision and keratometry in children and young adults with progressive keratoconus. Methods: A retrospective medical records review of patients aged 22 years or younger with keratoconus who underwent corneal crosslinking between January 2013 and November 2019 at Bye...

Purpose: Retinopathy of Prematurity (ROP) has been suggested to be increasing in Africa. However, it was only previously documented as a cause of blindness in 8 of 48 (16.7%) sub-Saharan African countries. The purpose of this study was to better understand the magnitude and breadth of blindness from ROP in sub-Saharan Africa. Methods:A questionnair...

Importance Glaucoma-related adverse events constitute serious complications of cataract removal in infancy, yet long-term data on incidence and visual outcome remain lacking. Objective To identify and characterize incident cases of glaucoma and glaucoma-related adverse events (glaucoma + glaucoma suspect) among children in the Infant Aphakia Treat...

Purpose: Prediction of refraction after cataract surgery in children is limited by the variance in rate of refractive growth (RRG3). This study compared RRG3 in aphakic and pseudophakic eyes to their fellow, normal eyes in the Infant Aphakia Treatment Study (IATS). Setting: 12 clinical sites in the United States. Design: Randomized clinical tr...

One of the most common causes of deprivation amblyopia is a unilateral congenital cataract (UCC). Deprivation amblyopia can be mitigated in these eyes with early cataract extraction followed by refractive correction with a contact lens or intraocular lens and part-time occlusion therapy. However, despite such labor- and cost-intensive treatment, a...

Purpose: To report outcomes of secondary intraocular lens (IOL) implantation in the Infant Aphakia Treatment Study (IATS) SETTING:: Multicenter clinical practice DESIGN:: Secondary analysis of patients enrolled in a randomized clinical trial METHODS:: Details regarding all secondary IOL surgeries conducted in children enrolled in the IATS were com...

To determine whether the fellow eye of children who have undergone unilateral cataract extraction in the first year of life are at increased risk of injury and vision loss, the 10.5-year data on 109 of 114 children enrolled in the Infant Aphakia Treatment Study were examined. Based on this limited data, it was estimated that the fellow eye is at gr...

Central disruption of fusion refers to a subject’s inability to align images, resulting in constant diplopia. Severely reduced vergences, or vergence anomalies, producing markedly decreased fusional amplitudes resembling fusional disruption have not been reported previously with convergence insufficiency. We report 3 patients with severe vergence a...

Purpose To evaluate outcomes of bilateral cataract surgery in children ages 7-24 months and compare rates of adverse events (AE) to other Toddler Aphakia and Pseudophakia Study (TAPS) registry outcomes. Design Retrospective clinical study at 10 IATS sites. Statistical analyses comparing this cohort to previously reported TAPS registry cohorts. Pa...

Objectives: To report the myopic shift in the aphakic eyes of a cohort of children who underwent unilateral cataract surgery during infancy and were then followed longitudinally for 10.5 years. Methods: One-half of the children enrolled in the Infant Aphakia Treatment Study (IATS) were randomized to aphakia and contact lens correction after unil...

Primary intraocular lens (IOL) implantation is performed when a cataract is removed and an IOL is implanted at the time of cataract surgery. Lensectomy is recommended for any visually significant lens opacity in a child. Patients who are less than 7 months of age are left aphakic in the developed world. However, in developing countries primary IOL...

Purpose To survey current oxygen management, screening criteria, and methods for treating retinopathy of prematurity (ROP) in sub-Saharan Africa. Methods An online survey was sent to ophthalmologists and neonatologists practicing in sub-Saharan Africa. Results Ophthalmologists and neonatologists from 15 of 49 countries (31%) in sub-Saharan Africa...

Purpose To report the change in globe axial length (AL) from the time of unilateral cataract surgery at age 1-7 months to age 10.5 years for infants enrolled in the Infant Aphakia Treatment Study, and to compare AL growth of operated eyes with that of fellow unoperated eyes. Design Comparative case series. Methods Axial length growth was analyzed...

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...

Importance Although intraocular lenses (IOLs) are often implanted in children, little is known whether primary IOL implantation or aphakia and contact lens correction results in better long-term visual outcomes after unilateral cataract surgery during infancy. Objective To compare long-term visual outcomes with contact lens vs IOL correction follo...

Purpose: To evaluate outcomes of bilateral cataract surgery in infants 1 to 7 months of age performed by Infant Aphakia Treatment Study (IATS) investigators during IATS recruitment and to compare them with IATS unilateral outcomes. Design: Retrospective case series review at 10 IATS sites. Participants: The Toddler Aphakia and Pseudophakia Stu...

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...

Importance Cataract is an important cause of visual impairment in children. Outcomes reported from a large clinical disease-specific registry can provide real-world estimates of visual outcomes and rates of adverse events in clinical practice. Objective To describe visual acuity and refractive error outcomes, as well as rates of amblyopia, glaucom...

Purpose: Using data from the Infant Aphakia Treatment Study, we examined the relationship between adherence to patching and parenting stress. Methods: Caregivers completed the Parenting Stress Index 3 months after surgery (n = 106), after a visual acuity assessment at 12 months of age (n = 97), and at 4.25 (n = 96) years of age. Patching was rep...

Methotrexate (MTX) is standard treatment in pediatric chronic anterior uveitis (CAU). Addition of tumor necrosis factor-α inhibitors (TNFi) is often needed. We describe the timing and risk factors for TNFi use in children with CAU on MTX. In this retrospective study, we reviewed 51 records, and 46 met inclusion criteria. Primary outcome was the add...

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...

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 determine whether grating acuity at age 12 months can be used to predict recognition acuity at age 4.5 years in children treated for unilateral congenital cataract enrolled in the Infant Aphakia Treatment Study (IATS). Methods: Traveling testers assessed monocular grating acuity at 12 months of age (Teller Acuity Card Test [TACT]) an...

Atopic dermatitis (AD) is a common inflammatory skin condition during childhood. It is reported to affect more than 10% of children in the United States.¹ It usually has its onset before 2 years of age, and more than 50% of cases resolve by adolescence. The disease often has a chronic waxing and waning course and is known to be part of the atopic t...

Congenital cataracts are the primary cause of treatable childhood blind- ness worldwide, affecting about four infants per 10,000 live births. Current surgical techniques have helped thousands of patients, but the limitations of these techniques led Lin et al. to report an alternative approach that they claim leads to a regenerated lens with refract...

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...

Importance Although contact lenses have been used for decades to optically correct eyes in children after cataract surgery, there has never been a prospective study looking at contact lens adherence in children with aphakia, to our knowledge. Objective To evaluate contact lens adherence and its association with visual outcome in a cohort of childr...

Objectives: Surveys are an important tool to assess the impact of research on physicians' approach to patient care. This survey was conducted to assess current practice patterns in the management of infantile cataracts in light of the findings of the Infant Aphakia Treatment Study. Methods: Pediatric ophthalmologists were emailed a link to the s...

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...

Purpose: To report the prevalence of anisometropia at age 5 years after unilateral intraocular lens (IOL) implantation in infants. Design: Prospective randomized clinical trial METHODS: Fifty-seven infants in the Infant Aphakia Treatment Study (IATS) with a unilateral cataract were randomized to IOL implantation with an initial targeted postoper...

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 To report the longitudinal change in axial length (AL) from the time of unilateral cataract surgery at age 1 to 7 months to age 5 years, and to compare AL growth of operated eyes with that of fellow unoperated eyes. Design Comparative case series. Participants Infants enrolled in the Infant Aphakia Treatment Study (IATS). Methods The AL...

Purpose: To report the myopic shift at 5 years of age after cataract surgery with intraocular lens (IOL) implantation for infants enrolled in the Infant Aphakia Treatment Study (IATS). Methods: Refractions were performed at 1 month and every 3 months postoperatively until age 4 years and then at ages 4.25, 4.5, and 5 years. The change in refract...