Prevention Of Visual Impairment Research Articles

Ocular Complications of Rheumatic Diseases of Childhood

The association between inflammatory ocular and articular disease is a strong one, although the pathogenesis of this relationship is obscure. For the physician or surgeon caring for children with chronic arthritis, awareness of the risk of chronic asymptomatic anterior uveitis is essential if early diagnosis, treatment, and prevention of visual impairment are to be accomplished. This is particularly true for children with pauciarticular-onset juvenile rheumatoid arthritis or psoriatic arthritis. Acute symptomatic anterior uveitis is characteristic of disorders such as ankylosing spondylitis. Whereas this disease is initially more unpleasant for the child, it has a good long-term prognosis.

IMPORTANCE OF EARLY SURGICAL TREATMENT OF CRANIOSYNOSTOSIS

One hundred and twenty children have been treated surgically for premature fusion of the cranial sutures in this clinic. Thirty-six of these have been operated on in the first six months of life and constitute the material on which this report is based. These have included 19 instances of sagittal suture closure, 10 of coronal closure, 5 of multiple suture involvement and 2 miscellaneous cases. The marked reduction in incidence and degree of mental retardation, the prevention of visual impairment, and the improvement in cosmetic appearance which can be achieved by recognition and surgical treatment of this lesion in early infancy are emphasized. The operation of choice in this clinic is linear craniectomy parallel to the suture which is prematurely fused with insertion of polyethylene film over the bony margins to delay closure. With proper precautions and supportive treatment this type of surgery is well tolerated and the complications are negligible during the first few months of life.