Applying newer technology to your practice in pediatric ophthalmology and strabismus

Abstract

Relevance: Imaging modalities like optical coherence tomography enable us to view and document details of ocular anatomy. These tools which are commonly used by our colleagues in cornea, glaucoma and retina, should be incorporated in the pediatric ophthalmology practice. Posterior segment OCT can be used to objectively monitor children with glaucoma, measure RNFL changes in papilledema or optic atrophy, study foveal morphology in diseases like retinoschisis. Anterior segment OCT can be used to assess anterior chamber depth, measure white-to-white distance, document the thickness of both the ciliary body and lens in children with anterior segment abnormalities. Newer technology now allow us to acquire high-quality ROP images, making telemedicine screening for ROP viable. Various computer programs have been developed to measure vascular dilation and/or tortuosity in premature infants. These measurements will be useful to study the evolution and mechanism of plus disease, correlate with prognosis and affect treatment decisions in ROP. RetCAM with fundal fluorescein angiography is useful in management of pediatric retina pathology. Extraocular muscle imaging by MRI is a valuable adjunct in evaluation of complex strabismus like myopic strabismus fixus, strabismus post endoscopic sinus surgery.