Paediatric vs adult retinal detachment
by Admin
Posted on 07-08-2022 01:18 PM
Objective: to evaluate the causes, incidences, characteristics, and
treatment
outcomes of paediatric vs adult retinal detachment.
patients
and methods: one hundred and sixty (136 patients) out of 2408 consecutive retinal detachments (6. 6%) at our
facility
occurred in children under the age of 18
years
. Of them, 144 eyes (90%) of 127 (93%) children were treated and compared with a sample of 56 consecutive retinal detachments in 50 adults (over the age of 18 years). The parameters for comparison included cause,
type
of retinal detachment, its extent, macular involvement,
number
of tears,
number
and
types
of surgery, and the anatomic and functional surgical outcome.
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Adults can have strabismus or misaligned eyes just like children. The strabismus seen in adults may be a residual problem from the strabismus they had as a child that either was not corrected or has recurred. Strabismus can also occur as a new problem in adults who have never had any previous strabismus. This new strabismus can result because of a stroke, tumors, certain neurologic
conditions
, diabetes, a brain or ocular injury, following other
eye
surgery such as retinal detachment surgery or in many cases for no identifiable
reason
. Strabismus in adults can cause disabling double vision, reduced binocularity, limitation of the peripheral visual field and an appearance that makes it difficult to function normally in the
work
and social
environment
.
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Adult & Pediatric Eye Muscle Surgery
Pediatric ophthalmologists
treat
all
medical
and surgical aspects of pediatric eye
disease
.
Pediatric ophthalmologists are also experts for
patients
with adult strabismus (misaligned eyes. ) in fact, the official name for the fellowship after 4 years of ophthalmology surgical residency is “pediatric ophthalmology and adult strabismus. ” at first some adult patients will think that they are in the wrong clinic when the see the toys and the train table, but they soon realize they are in the right
place
to get their complex eye alignment fixed. Many adult patients are also under the impression that nothing can be done to fix their double vision or strabismus.
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“i’m an adult. Why should i see a pediatric ophthalmologist?”
for most of your eye
care
needs as an adult, you really are best served by your
general
ophthalmologist. However, issues of double vision and eye misalignment are ones that your general ophthalmologist does not deal with nearly as frequently as he does other problems, whereas a pediatric ophthalmologist deals with these issues all
day
every
day
. Thus a pediatric ophthalmologist is prepared to evaluate and
treat
your double vision or eye misalignment in a more efficient way,
including
an appropriate recommendation regarding whether further medical
work
-up or a scan of the brain may be needed.
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Children don’t know that they can’t see, but we do. We specialize in the diagnosis and
treatment
of medical and surgical children’s eye
disorders
, such as amblyopia (‘lazy eye’), congenital and juvenile cataracts, refractive errors (near-sightedness, far-sightedness, astigmatism) and strabismus (eye muscle imbalances). In addition to years of
experience
in the
care
of children with vision disorders, we also care for children and adults who
require
ophthalmic plastic surgery for issues like droopy eyelids, droopy eyebrows or tear duct problems. We also
offer
botox injections and filler injections for adults. Strabismus (eye muscle imbalances) in adults may be particularly challenging.
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Many special needs patients deal with communication, emotional, learning, and sensory challenges associated with their
medical
condition
that make wearing glasses and
contact
lenses extremely difficult, even impossible. While refractive surgery such as prk (photorefractive keratectomy) and lasik (laser in situ keratomileusis) is usually reserved for adults, wills eye hospital now has a refractive surgery
program
for children. Pediatric patients who are three
years
of age and older and have serious medical conditions such as autism, cerebral palsy, craniofacial deformities, orthopedic deformities, and other neurobehavioral abnormalities may be eligible for refractive surgery performed under anesthesia. This
type
of corrective refractive surgery is considered a viable alternative for special needs patients who also have:.
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Adult & Pediatric Strabismus Surgery
Nausea alone is a difficult entity to quantify in children, who generally have a higher incidence of pov than adults. Pov is a well-recognized complication following strabismus surgery, particularly in children over the age of 2 years.
experience
suggests that about two-thirds of children undergoing strabismus surgery vomit if no preventative measures are taken. A systematic review of publications between 1981 and 1994 on vomiting in children following squint surgery established a mean incidence of vomiting within 6 h of 54% in children receiving no prophylactic anti-emetic and 59% within 48 h. 3the
reason
for an increased incidence of vomiting following squint surgery and its precise mechanism remain unknown but it is postulated to be
part
of an oculo-emetic reflex, involving the ophthalmic division of the trigeminal nerve and the vomiting centre in the medulla.
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Wilmer's division of pediatric ophthalmology and adult strabismus treats the
full
spectrum of children's vision
problems
. Our specialists are among the top experts in their field and have advanced training in strabismus (both pediatric and adult), amblyopia (lazy
eye
), congenital and pediatric cataracts, retinopathy of prematurity, pediatric glaucoma and pediatric neuro-ophthalmologic
disorders
.
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Serious anesthesia complications, such as brain damage or death, are exceptionally rare. Generally,
healthy
adults tolerate anesthesia well. Whenever possible, elective eye surgery should be avoided when you are ill. Anesthesiologists and surgeons should be informed of all medical
conditions
and all medications the
patient
is taking. They should also be informed of any anesthetic
problems
the patient or any blood relative has
experienced
, as there are some rare hereditary conditions, which are associated with a greater
risk
. Although strabismus surgery is usually quite routine, the anesthesiologist extensively monitors patients while they are asleep. Serious reactions to anesthesia are extremely rare.
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Mbbs (singapore), mrcsed (ophth, uk)
mmed (ophth, singapore)
fellowship,
university
of toronto (aapos accredited, acgme)
cv highlights
medical director, adult & child eye (ace) clinic 2019
adjunct assistant professor,
department
of ophthalmology, nus yong loo lin school of medicine
immediate past head of paediatric ophthalmology and strabismus, national university hospital singapore (nuhs)
meritorious
service
award for eye and vision
health
awards 2017
international member of the american association for pediatric ophthalmology and strabismus since 2016
member, paediatrics subspecialty committee, college of ophthalmologists, academy of medicine, singapore since 2016
fellowship at hospital for sick children, toronto, canada 2013
fellow, royal college of surgeons of edinburgh since 2013
reserve valedictorian, faculty of medicine, nus 2005.
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Telling It Like It Is
Orlando — in this surgical video presentation from cataract surgery: telling it like it is, hazem m. Yassin, md, of cairo
university
, egypt, shows the many differences in performing cataract surgery in a pediatric vs. Adult
patient
.
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Intraocular Lens Power Calculation in Children
Examination under anesthesia is carried out to record the essential parameters for intraocular lens (iol) power calculation. The immaturity of an infant's organ
system
and thermoregulation
put
them at greater
risk
from
general
anesthesia. The most
life
-threatening risk to an infant is postoperative apnea. The child preferably is taken up for surgery after the 1st month of birth or 44
weeks
of gestational age in preterm infants as they are prone to apnea in postoperative period. [ 62 ].
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