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New Orleans Academy of Ophthalmology

AT THE CROSSINGS:

PEDIATRIC

OPHTHALMOLOGY AND

STRABISMUS

edited by

Robert J. Balkan, George S. Ellis Jr. and H. Sprague Eustis

AT THE CROSSINGS:

PEDIATRIC OPHTHALMOLOGY AND STRABISMUS

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AT THE CROSSINGS:

PEDIATRIC

OPHTHALMOLOGY AND

STRABISMUS

edited by Robert J. Balkan, George S. Ellis Jr. and H. Sprague Eustis

Proceedings of the 52nd Annual Symposium of the New Orleans Academy of Ophthalmology, New Orleans, LA, USA, February 14-16, 2003

Kugler Publications/The Hague/The Netherlands

ISBN 90 6299 198 X

Distributors:

For the U.S.A. and Canada:

Pathway Book Service.

4 White Brook Road

Gilsum, NH 03448 Telefax (603) 357 2073

E-mail: pbs@pathwaybook.com

For all other countries: Kugler Publications P.O. Box 97747

2509 GC The Hague, The Netherlands Telefax (+31.70) 3300254

website: www.kuglerpublications.com

© Copyright 2004 Kugler Publications

All rights reserved. No part of this book may be translated or reproduced in any form by print, photoprint, microfilm, or any other means without prior written permission of the publisher. Kugler Publications is an imprint of SPB Academic Publishing bv, P.O. Box 97747

2509 GC The Hague, The Netherlands

Table of contents

 

v

Contents

 

 

Preface

 

vii

President’s letter

 

viii

History

 

 

History of the New Orleans Academy of Ophthalmology, Arthur Jampolsky

3

History of pediatric ophthalmology and the American Association of

 

Pediatric Ophthalmology and Strabismus, Marshall M. Parks

15

Round Table: One hundred years of experience. What I would have done

 

differently and what needs to be done in the future, Forest D. Ellis,

 

Moderator

 

19

Cataract/Refractive Update

 

 

Etiology of pediatric cataracts, Forrest D. Ellis

 

27

Monocular congenital cataracts. Is binocular vision too much to ask?, Kenneth

 

W. Wright and Mehmet Cem Mocan

 

45

Diplopia after LASIK surgery, Edward G. Buckley

 

55

Round Table: Seeing too well – diplopia after adult cataract surgery, Edward G.

 

Buckley, Moderator

 

67

Questions and Answers: Cataract update I, H. Sprague Eustis, Presiding

 

Physician

 

75

Monovision may be detrimental to patients with strabismus, Burton J.

 

Kushner and Constance E. West

 

77

My experience with pediatric refractive surgery, Kenneth W. Wright and

 

Mehmet Cem Mocan

 

87

Questions and Answers: Cataract update II, Robert J. Balkan, Presiding

 

Physician

 

93

Amblyopia/Strabismus Update

 

 

Why do early surgery for infantile esotropia?, Kenneth W. Wright and

 

Mehmet Cem Mocan

 

99

Dissociated vertical deviation – a nystagmus blockage phenomenon,

 

David L. Guyton

 

111

Surgery for dissociated vertical deviation – new approaches, David L.

 

Guyton

 

117

Complications of inferior oblique surgery, Burton J. Kushner

121

Round Table: Surgery for accommodative and partially accommodative

 

esotropia, Kenneth W. Wright, Moderator

 

133

Round Table: Pearls in the management of exotropia,

Burton J. Kushner,

 

Moderator

 

145

Questions and Answers: Strabismus update I, George

S. Ellis, Presiding

 

Physician

 

151

Evaluation of the adult with diplopia, Forrest D. Ellis

 

157

vi

Table of contents

 

 

 

The dragged-fovea diplopia syndrome, David L. Guyton

 

169

Guidelines for the surgical treatment of paralytic strabismus, Edward

 

G. Buckley

 

173

Round Table: Adjustable suture technique and uses, David L. Guyton,

 

Moderator

 

199

Questions and Answers: Strabismus update II, Robert Gordon, Presiding

 

Physician

 

209

New optotypes: are they better than Allen cards?, Kenneth W. Wright,

 

Mehmet Cem Mocan, Mario Najera-Covarrubias and Loren Ong

213

Anisometropic amblyopia, Forrest D. Ellis

 

219

Round Table: Pearls for amblyopia diagnosis and treatment (Masquerade

 

syndrome), Forrest D. Ellis, Moderator

 

223

Questions and Answers: Amblyopia update, M. Tere Vives, Presiding Physician

229

Oculoplastics Update

 

 

Childhood blepharoptosis: diagnostic evaluation of the patient,

 

 

Forrest D. Ellis

 

233

Results of multi-pass nasolacrimal duct probing, Kenneth W. Wright,

 

Mehmet Cem Mocan, Mario Najera-Covarrubias and Nancy Suarez

251

Round Table: Congenital epiphora: when and where to probe, tubes or

 

balloons, internal or external DCR, James A. Katowitz, Moderator

257

Questions and Answers: Plastic surgery update I, Kyle Acosta, Presiding

 

Physician

 

263

Childhood ptosis: an oculoplastic perspective, J.A. Katowitz and F. Kherani

267

Round Table: Myths and realities in oculoplastic surgery, James A.

 

 

Katowitz, Moderator

 

283

Questions and Answers: Plastic surgery update II, Constance Fry, Presiding

 

Physician

 

291

Appendix

 

 

The selective laser trabeculoplasty laser and its role in rational glaucoma

 

therapy, James B. Wise

 

299

Questions and Answers, Daniel A. Long, Presiding Physician

 

307

Questions and Answers: Refractive update, Marguerite B. McDonald,

 

Presiding Physician

 

309

Index of authors

 

313

Table of contents

vii

 

 

Preface

On February 14th-16th, 2003, the New Orleans Academy of Ophthalmology (NOAO) hosted its 52nd Annual Symposium, featuring Pediatric Ophthalmology and Strabismus. Once again, the NOAO was able to attract the most innovative and respected authorities in their field. Unique to this meeting, however, was the appearance of three of the legends of Pediatric Ophthalmology and Strabismus who have significantly contributed to the success of past NOAO Symposia. Marshall M. Parks, Arthur Jampolsky, and Gunter von Noorden returned once again to this year’s meeting. Watching both present and past luminaries discuss and debate important topics was truly special. Additionally, we widened the scope of subjects to include plastics, cataracts, and orbital disease as they pertain to Pediatric Ophthalmology.

The speakers are to be commended for their inordinate efforts to bring this meeting and book to fruition. Each speaker prepared multiple lectures and panel discussions, and also participated in question and answer sessions. Their commitment to preparing the chapters and discussions for this book will be evident to all who read it.

We wish to thank all the speakers/authors for their efforts on behalf of the NOAO and the readers of this publication. We also wish to thank Laurence W. Arend, MD, President of the NOAO, and the Board of Directors, for supporting this program and its publication. We wish to give a special thanks to Amber Howell, Executive Director of the NOAO, for her tremendous organization and creativity. Finally, we thank Kugler Publications for their editorial skills and timely production of this book.

Robert J. Balkan, MD, George S. Ellis, Jr., MD, and H. Sprague Eustis, MD Editors

viii

Author and Author

 

 

President’s letter

 

On behalf of the Board of Directors of the New Orleans Academy of Ophthalmology, I would personally like to thank the speakers and the program committee for the success of the 52nd Annual Symposium on February 14th-16th, 2003. The editors, Drs George S. Ellis Jr., Robert J. Balkan, and H. Sprague Eustis, have put together a superb text that will serve as an important reference in the ophthalmic literature for the benefit of the ophthalmic community of the present and future.

The New Orleans Academy of Ophthalmology was founded in 1951 as a result of the combined wisdom and vision of the Chairmen of the Tulane and Louisiana State University School of Medicine Ophthalmology Departments, Drs James H. Allen and George Haik, Sr., together with the New Orleans ophthalmic community. The first symposium was held in 1952 and invited speakers were Sir Stewart Duke-Elder, Paul Chandler, and Peter Kronfeld. There have been six previous symposia on ocular motility and strabismus, the first having taken place in 1955. Dr Arthur Jampolsky has written a fascinating history of the New Orleans Academy meetings, which is included in this volume of the Transactions. I commend it to the reader’s attention.

Special thanks are in order for the Eye, Ear, Nose and Throat Foundation, without whose generous support neither the Transactions nor the meeting would be possible. The Foundation was formed in 1981 to support the Eye, Ear, Nose and Throat Hospital, which was founded in 1889 for the purpose of providing medical care to the indigent population of New Orleans. The Foundation’s mission is to provide funding for medical research and education for ophthalmology and otolaryngology, as well as direct patient care.

The driving force behind all our efforts is our Executive Director, Amber Howell. The Transactions, the meeting, and our success in general, are in large part due to her energy, creativity, and drive. She gently nudged and prodded us all along to get the meeting organized on time, within budget, and with rave reviews by all involved.

Thanks again to the program committee, who put together such a significant symposium, to the editors of the Transactions, and most especially to the speakers, without whom none of this would be possible.

Laurence W. Arend, MD

President, New Orleans Academy of Ophthalmology