Browsing by Author "Sprunger, Derek T."
Now showing 1 - 7 of 7
Results Per Page
Sort Options
Item Amblyopia Preferred Practice Pattern(Elsevier, 2023) Cruz, Oscar A.; Repka, Michael X.; Hercinovic, Amra; Cotter, Susan A.; Lambert, Scott R.; Hutchinson, Amy K.; Sprunger, Derek T.; Morse, Christie L.; Wallace, David K.; American Academy of Ophthalmology Preferred Practice Pattern Pediatric Ophthalmology/Strabismus Panel; Ophthalmology, School of MedicineItem Current trends among pediatric ophthalmologists to decrease myopia progression—an international perspective(Springer, 2018-12) Zloto, Ofira; Wygnanski-Jaffe, Tamara; Farzavandi, Sonal K.; Gomez-de-Liaño, Rosario; Sprunger, Derek T.; Mezer, Eedy; Ophthalmology, School of MedicinePurpose To explore what the current worldwide preferred practice patterns of pediatric ophthalmologists are to decrease myopia progression among their patients. Methods A questionnaire was sent to all members of supranational and national pediatric ophthalmology and strabismus societies. Results The questionnaire was fully completed by most respondents 90.10% (847 of 940 responses). Fifty-seven percent (457) routinely treat to decrease myopia progression. The most common parameter to initiate treatment was a myopic increase of 1 diopter/year or more (74.8%, 246). Seventy percent (345) prescribed eye drops. Atropine 0.01% was the most popular (63.4%, 277) followed by atropine 1% (10.9%, 48) and atropine 0.5% (8.9%, 39). Eighty-six percent (394) of the respondents advised to spend more time outdoors, to reduce the amount of time viewing screens (60.2%, 277), and cutback the use of smart phones (63.9%, 294). Conclusions Most pediatric ophthalmologists treat to decrease myopia. They employ a wide variety of means to decrease myopia progression. Atropine 0.01% is the most popular and safe modality used similarly to recent reports. However, there is no consensus when treatment should be initiated. Further prospective studies are needed to elucidate the best timing to start treatment and the applicability of recent studies in the Asian population to other ethnic groups. This will improve the ability to update pediatric ophthalmologist with evidenced-based treatment options to counter the myopia epidemic.Item Pediatric Eye Evaluations Preferred Practice Pattern(Elsevier, 2023) Hutchinson, Amy K.; Morse, Christie L.; Hercinovic, Amra; Cruz, Oscar A.; Sprunger, Derek T.; Repka, Michael X.; Lambert, Scott R.; Wallace, David K.; Ophthalmology, School of MedicineItem A pilot randomized clinical trial of intermittent occlusion therapy liquid crystal glasses versus traditional patching for treatment of moderate unilateral amblyopia(Elsevier, 2016-08) Wang, Jingyun; Neely, Daniel E.; Galli, Jay; Schliesser, Joshua; Graves, April; Damarjian, Tina G.; Kovarik, Jessica; Bowsher, James; Smith, Heather A.; Donaldson, Dana; Haider, Kathryn M.; Roberts, Gavin J.; Sprunger, Derek T.; Plager, David A.; Department of Ophthalmology, IU School of MedicinePURPOSE: To compare the effectiveness of intermittent occlusion therapy (IO therapy) using liquid crystal glasses and continuous occlusion therapy using traditional adhesive patches for treating amblyopia. METHODS: Children 3-8 years of age with previously untreated, moderate, unilateral amblyopia (visual acuity of 20/40 to 20/100 in the amblyopic eye) were enrolled in this randomized controlled trial. Amblyopia was associated with strabismus, anisometropia, or both. All subjects had worn any optimal refractive correction for at least 12 weeks without improvement. Subjects were randomized into two treatment groups: a 4-hour IO therapy group with liquid crystal glasses (Amblyz), set at 30-second opaque/transparent intervals (occluded 50% of wear time), and a 2-hour continuous patching group (occluded 100% of wear time). For each patient, visual acuity was measured using ATS-HOTV before and after 12 weeks of treatment. RESULTS: Data from 34 patients were available for analysis. Amblyopic eye visual acuity improvement from baseline was 0.15 ± 0.12 logMAR (95% CI, 0.09-0.15) in the IO therapy group (n = 19) and 0.15 ± 0.11 logMAR (95% CI, 0.1-0.15) in the patching group (n = 15). In both groups improvement was significant, but the difference between groups was not (P = 0.73). No adverse effects were reported. CONCLUSIONS: In this pilot study, IO therapy with liquid crystal glasses is not inferior to adhesive patching and is a promising alternative treatment for children 3-8 years of age with moderate amblyopia.Item Practice patterns to decrease myopia progression differ among paediatric ophthalmologists around the world(BMJ, 2020) Leshno, Ari; Farzavandi, Sonal K.; Gomez-de-Liaño, Rosario; Sprunger, Derek T.; Wygnanski-Jaffe, Tamara; Mezer, Eedy; Ophthalmology, School of MedicineIntroduction Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia. Methods Global responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature. Results Treatment rates varied significantly between geographical regions (mean 57%, range 39%–89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)—mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001). Discussion The utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy. Conclusion Paediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children.Item Type IV Duane Syndrome(Elsevier, 2016-08) Schliesser, Joshua A.; Sprunger, Derek T.; Helveston, Eugene M.; Department of Ophthalmology, IU School of MedicinePurpose To identify cases of synergistic divergence whose characteristics suggest that this entity is a form of Duane syndrome. Methods The records of all patients with a Duane syndrome diagnosis, including standardized eye position photographs, from the E-Consultation program of Cybersight, Orbis International were analyzed. Results A total of 350 Duane syndrome cases were identified. Of these, 19 (5%) had features consistent with synergistic divergence, or type 4 Duane syndrome. Of the 19, 16 (84%) were male, 15 (79%) had palpebral fissure narrowing, all had anomalous head posture, and 18 (95%) were exotropic. Only 9 (47%) patients were reported to have undergone surgery. Conclusions Synergistic divergence is a rare entity with features similar to those of Duane syndrome. We suggest that this entity be classified as type 4 Duane syndrome, because it has unique findings and an innervation pattern that differs from the other 3 recognized types.Item Vertical Muscle Transposition with Augmentation for Treatment of Exotropia Caused by Iatrogenic Lost Medial Rectus Muscle(Taylor & Francis, 2016) Elkamshoushy, A. A.; El Sayed, D. A.; Sprunger, Derek T.; Department of Ophthalmology, IU School of MedicinePurpose: To evaluate the results of vertical muscle transposition with augmentation in cases of exotropia caused by iatrogenic lost medial rectus muscle. Methods: This is a retrospective review of 5 cases of lost medial rectus with exotropia and marked limitation of adduction that underwent surgery. All cases had a history of strabismus surgery on the medial rectus and failed attempt at retrieval of the lost muscle. Results: Five patients fulfilled the criteria. Full tendon vertical muscle transposition with augmentation sutures was done for all cases. Surgery led to a significant reduction of the angle of exotropia 25.8±13.6 ?D (P=0.027) and improvement in adduction of 7.5±3.8 degrees (P=0.034). There were no complications. Conclusions: Isolated vertical muscle transposition with augmentation is a useful option to improve the exotropia and adduction deficit in patients with iatrogenic lost medial rectus muscle.