Pediatric Ophthalmology

Preface
Contents
About the Author
1: Epidemiology and Pathogenesis of Myopia
1.1 Trends in Myopia Epidemics
1.1.1 Global
1.1.2 East Asia
1.1.3 South Asia
1.1.4 Middle East, Europe, Africa, and America
1.2 High Myopia
1.2.1 Definition
1.2.2 Influence of Age and Urbanization
1.2.3 Current and Predicted Trends of High Myopia
1.3 Pathological Myopia
1.3.1 Definition
1.3.2 Current and Predicted Trends of Pathologic Myopia
1.3.3 Myopia Incidence and Progression
1.3.4 Emmetropisation and Refractive Development
1.4 Ocular Expansion Models
1.4.1 Role of the Retina in Regulating the Ocular Growth
1.4.2 Central vs. Peripheral Retina
1.4.3 Theories Related to Peripheral Optics and Retinal Shape in Myopia
1.4.4 Changes in the Choroid
1.4.5 Changes in the Sclera
1.4.6 Optical, Biomechanical, and Neural Mechanisms in Myopiageneis
1.4.6.1 Accommodative Lag Theory
1.4.6.2 Mechanical Tension Theory
1.4.6.3 Higher-Order Aberrations
1.4.6.4 Near-Induced Transient Myopia (NITM)
1.4.6.5 Role of Convergence and Extraocular Muscles
1.4.6.6 Role of ON-OFF Pathway
1.4.7 Role of Genetics and Other Factors in the Refractive Development
References
2: Update on Interventions to Slow Myopia Progression
2.1 Slowing Progression of Myopia: Pharmacological Measures
2.2 Slowing Progression of Myopia: Optical Interventions
2.2.1 Spectacle-Based Strategies
2.2.2 Contact Lens Based Strategies
2.2.3 Orthokeratology
2.2.4 Combination Strategies
2.3 Preventing the Onset of Myopia
2.4 Long-Term Efficacy, Rebound, and Side Effects
2.5 Poor or Slow Responders to Myopia Control
2.6 Clinical Management of Myope
2.6.1 Risk Factors for Progression
2.6.2 Examining the Eye
2.6.3 Choosing a Treatment Plan, Realistic Goal Setting, and Follow-Up
2.7 Summary
References
3: Current Management of Amblyopia
3.1 Etiology
3.2 Areas of Visual Perception Affected
3.3 Identifying Amblyopia
3.4 Treatment Goals
3.5 Treatment Options
3.6 When to Extend Treatment?
3.7 Follow-up Examinations
3.8 When to Taper/Stop Treatment?
3.9 Amblyopia and Risk to Fellow Eye
3.10 Amblyopia as a Public Health Focus
References
4: Pediatric Refractive Surgery
4.1 Classification and History of Pediatric Refractive Surgery
4.2 The Need for Pediatric Refractive Surgery
4.3 Unique Aspects of Refractive Surgery for the Pediatric Patient
4.4 Excimer Laser
4.5 Phakic Intraocular Lens (pIOL)
4.6 Refractive Lens Exchange (RLE)
4.7 Future Technologies
References
5: Advances in the Management of Retinopathy of Prematurity
5.1 Introduction
5.2 Classification
5.2.1 Risk Factors
5.2.2 Screening Guidelines
5.2.3 Imaging for ROP
5.3 Optical Coherence Tomography (OCT)
5.4 OCT Angiography (OCT-A)
5.5 Fundus Fluorescein Angiography (FFA)
5.6 Telemedicine in ROP
5.7 Management
5.7.1 Laser Therapy
5.7.2 Surgical Management
5.7.3 Anti-VEGF Treatment
5.7.4 Artificial Intelligence (AI) and Deep Learning in ROP
5.7.5 Medicolegal Aspects in ROP
References
6: Periocular Infantile Hemangiomas
6.1 Introduction
6.2 Epidemiology
6.3 Pathogenesis
6.4 Clinical Presentation
6.5 Diagnosis
6.6 Differential Diagnosis
6.7 Complications
6.8 Management
6.9 Conclusion
References
7: Current Management of Pediatric Uveitis
7.1 Introduction to Pediatric Uveitis
7.2 Juvenile Idiopathic Arthritis-Associated Uveitis
7.2.1 Epidemiology
7.2.2 Screening
7.2.3 Treatment
7.2.4 Complications
7.3 Tubulointerstital Nephritis and Uveitis (TINU) Syndrome
7.3.1 Epidemiology
7.3.2 Screening
7.3.3 Treatment
7.4 Blau-Jabs Syndrome (Juvenile Systemic Granulomatosis)
7.4.1 Epidemiology
7.4.2 Screening
7.4.3 Etiology
7.4.4 Treatment
7.4.5 Complications
7.5 Behçet Disease
7.5.1 Epidemiology
7.5.2 Treatment
7.5.3 Complications
7.6 Intermediate Uveitis
7.6.1 Epidemiology
7.6.2 Screening
7.6.3 Treatment
7.6.4 Complications
7.7 Pediatric Infectious Uveitis: Ocular Tuberculosis and Toxocariasis
7.7.1 Ocular Tuberculosis
7.7.1.1 Epidemiology
7.7.2 Clinical Overview
7.7.3 Screening
7.7.4 Treatment
7.7.5 Complications
7.7.6 Ocular Toxocariasis
7.7.6.1 Epidemiology
7.7.7 Clinical Overview
7.7.8 Screening
7.7.9 Treatment
7.7.10 Complications
7.8 Cataract in Pediatric Uveitis Patients
7.9 Risk of Glaucoma
7.10 Summary
References
8: Update of Retinoblastoma Management
8.1 Introduction
8.2 Genetics of Retinoblastoma
8.3 Clinical Features and Staging of Disease
8.4 Pathology
8.5 Diagnosis
8.6 Treatment
8.6.1 Local
8.7 Systemic Chemotherapy
8.8 Intra-Arterial Chemotherapy
8.9 Intravitreal Chemotherapy
8.10 Radiation
8.11 Enucleation
8.12 Extraocular Retinoblastoma
8.13 Metastatic Retinoblastoma
8.14 Long-Term Visual Outcomes
References
9: Pseudotumor Cerebri Syndrome in Children: Current Diagnosis and Treatment
9.1 Introduction
9.2 Epidemiology
9.3 Symptoms
9.4 Diagnosis
9.4.1 Examination
9.4.2 Diagnostic Criteria
9.5 Treatment
9.6 Monitoring
9.7 Outcomes
9.8 Conclusion
References
10: Update on Pediatric Glaucoma
10.1 Childhood Glaucoma
10.1.1 Introduction
10.1.2 Classification
10.1.3 Genetics
10.2 Clinical Features
10.3 Diagnosis
10.3.1 Corneal Examination
10.3.2 Refraction
10.3.3 Anterior Segment Examination
10.3.4 Intraocular Pressure Measurement
10.3.5 Optic Nerve Examination
10.3.6 Optical Coherence Tomography
10.4 Management
10.4.1 Medical Therapy
10.4.2 Surgical Therapy
10.4.3 Angle Surgery
10.4.3.1 Goniotomy
10.4.3.2 Trabeculotomy
10.4.3.3 Trabeculectomy
10.4.4 Glaucoma Drainage Devices
10.4.5 Cyclodestruction
10.4.6 Visual Rehabilitation
References
11: Update on Congenital Cataract
11.1 Introduction
11.2 Epidemiology
11.3 Genetics
11.4 Treatment
11.4.1 Goals
11.4.2 Early Detection
11.4.3 Evaluation
11.4.4 Morphology
11.4.5 Surgical Treatment
11.4.6 Complications
References
12: Pediatric Corneal Transplantation
12.1 Introduction
12.2 Preoperative Consideration
12.2.1 Systemic Considerations
12.2.2 Ocular Considerations, Examination, and Imaging Modalities
12.2.3 Surgical Planning
12.2.4 Timing of Surgery
12.2.5 Counseling and Expectations
12.3 General Surgical Considerations
12.4 Penetrating Keratoplasty
12.4.1 Indications
12.4.2 Surgical Technique
12.4.3 Postoperative Management
12.4.4 Complications
12.4.5 Outcomes
12.5 Anterior Lamellar Keratoplasty
12.5.1 Indications
12.5.2 Surgical Technique
12.5.3 Complications
12.5.4 Outcomes
12.6 Endothelial Keratoplasty
12.6.1 Indications
12.6.2 Surgical Techniques and Challenges
12.6.3 Postoperative Management
12.6.4 Outcomes
12.7 What Does the Future Hold?
12.8 Conclusion
References
13: Current Management of Optic Pathway Glioma
13.1 Introduction
13.2 Defining Optic Pathway Gliomas
13.2.1 Symptoms
13.2.2 Prognostic Factors
13.2.3 Pathophysiology of NF1-Associated OPGs
13.3 Diagnosis
13.3.1 Dodge Classification
13.3.2 Screening
13.3.3 Additional Recommendations
13.3.4 Imaging and Diagnostics
13.3.4.1 MRI
13.3.4.2 DTI
13.3.4.3 CT
13.3.4.4 PET
13.3.4.5 OCT
13.3.4.6 VEPs
13.3.4.7 Biopsy
13.4 Treatment
13.4.1 Observation
13.4.2 Indications for Treatment
13.4.3 Chemotherapy
13.4.4 Radiation Therapy
13.4.5 Surgical Resection and Debulking
13.4.6 Novel Treatments and Future Directions
13.4.6.1 Murine Models
13.4.6.2 Molecular Targeting
13.5 Differences Between Pediatric and Adult Patients
References
14: Update on Non-accidental Trauma
14.1 Introduction
14.2 Epidemiology/Differential Diagnosis
14.3 Pathophysiology
14.4 Clinical Presentation/Evaluation/Workup
14.4.1 Workup
14.4.1.1 Ophthalmic Examination
14.4.2 Laboratory Tests
14.4.3 Imaging
14.5 Management/Expected Sequelae or Complications/Ancillary Consults
14.6 Primary/Secondary Prevention and Public/Parent Education
14.7 Ongoing New Research
References