e34 Volume 13 Number 1 / February 2009

of any retinal hemorrhage means that the child has been a victim ofabusive head trauma. There are a wide number of systemic and oc-ular conditions that may be associated with retinal hemorrhages inchildren, although supportive findings on ocular examination, physi-cal examination, history, or laboratory evaluation assist the team inidentifying those children who were likely abused. This workshopwill review the current state of the art research and literature regard-ing shaken baby syndrome/abusive head injury and retinal hemor-rhages. In addition, case presentations of children with retinalhemorrhages will be presented and opinions as to the workup andmanagement of such patients will be discussed. Time will be pre-served for the audience to submit cases for discussion as well.

134 Difficult problems: Nonstrabismus. Brian Forbes, Jane C.Edmond, Alex V. Levin, Scott Olitsky, Michael C. Struck, DavidWallace

In this workshop, we will discuss 5 patients with primary oculardisease processes, other than strabismus, whose diagnosis, find-ings, or treatment presents a clinical dilemma to the pediatric oph-thalmologist. The goal of the discussion will be to elucidate basiclines of thinking that should direct the clinician toward appropriatediagnostic and therapeutic solutions. The audience is encouragedto participate in the discussion.

135 The golden gateway to success: Managing diplopia in theadult patient. Katherine J. Fray, David T. Wheeler, Kyle A. Arnoldi,Paula M. Edelman, Paul H. Phillips, James D. Reynolds

Do you often find yourself in a fog trying to manage adults with dip-lopia? Does it seem like it's often an uphill struggle? Every practicehas its share of adult patients who can't seem to get it together.This course will give you some insight on how to hold these patientsat bay by using preoperative sensorimotor testing and postoperativeorthoptic intervention. Our panel of orthoptists and ophthalmologistswill share tips and pearls to improve your success in treating thesepatients. Using case examples, they will address topics such as:When is prism adaptation helpful? How can you minimize the riskof postoperative diplopia in a previously asymptomatic patient?How can you use prisms in free space as well as the synoptophoreto help guide surgical plans? Are fusional amplitudes important andcan they help predict outcome? When is postoperative diplopia de-sirable and when is it unacceptable? When do you consider reoper-ation? The careful collection and interpretation of clinical data in theadult patient with diplopia can make the difference between a suc-cessful or failed surgical plan. Find out what you need to do to clearthe fog and cross the bridge to success. Questions and commentsfrom the audience will be encouraged.

136 Does this child have glaucoma? Applying newer technologiesto the diagnosis and management of pediatric glaucoma. Sharon F.Freedman, Alex V. Levin, Allen D. Beck

Pediatric glaucoma sometimes presents with clear objectivesigns that make its diagnosis (though not necessarily its successfultreatment!) rather straightforward. Yet at other times, abnormalitiesof the optic nerve or other features of the child's case raise suspi-cion of the ''glaucoma'' diagnosis but doubt remains. This workshopis intended to review cases of known and suspected glaucoma, withemphasis on newer technologies and thorough discussion of whatthe ''experts'' really use to make (or exclude) the diagnosis of pedi-atric glaucoma. Technologies to be discussed include central cor-neal thickness and other features affecting pressure evaluation(including new devices for measuring intraocular pressure), optic

nerve head (and macular?) imaging (optical coherence tomography,etc.), visual field evaluation, and modern strategies for medicalmanagement of the high-risk or confirmed glaucoma case. Acase-based format will be used, and attendee questions and com-ments will be encouraged.

137 Reading, dyslexia, & vision therapy. Sheryl M. Handler, MeganRees

This workshop will give a comprenesive summary of the latestinformation on language acquisition, reading, dyslexia, and eye func-tions necessary to read. We will cover in-depth controversial theo-ries such as the magnocellular theory and the Irlen syndrome(scotopic sensitivity syndrome). Behavioral/developmental optomet-ric theories and practice will be reviewed. Behavioral optometrictesting, developmental lenses, and vision therapy will be extensivelydiscussed and examples shown. The participant will gain a thoroughunderstanding of the issues and controversies and be better equipedto discuss this subject with our patients and their families.

138 International childhood blindness. Sherwin Isenberg, TinaRutar, Tom Lietman, Ken Nischal, Ed Wilson, Tony Murray, RobertStamper, Bill Good, Elias Traboulsi

The World Health Organization estimates that approximately 1.4million children in the world are blind, and half of these cases arepotentially preventable. The causes of pediatric blindness vary by re-gion and by socioeconomic status. In high-income countries, retinop-athy of prematurity, cortical visual impairment, and optic nervehypoplasia predominate. In low-income countries, corneal scarringfrom measles, vitamin A deficiency, the use of harmful traditionaleye remedies, ophthalmia neonatorum, and infectious keratitis pre-dominate and are potentially preventable causes of blindness. Reti-nopathy of prematurity is becoming an increasingly important causeof blindness in middle-income countries, as premature infants aresurviving longer. In many parts of the world, consanguineous mar-riages have led to a high rate of blindness as the result of heritableconditions, including primary congenital glaucoma, retinal degener-ations, and other congenital ocular malformations. Cataracts remainan important contributor to blindness in low-income countries, espe-cially cataracts caused by maternal rubella infections. The surgicalmanagement, refractive management, and amblyopia treatment nec-essary for restoration of vision in cases of congenital cataracts posespecial challenges to ophthalmologists working in the developingworld. This symposium will focus on international childhood blind-ness in low and middle-income countries. Covered topics will includetrachoma, corneal blindness, pediatric ocular trauma, pediatric cat-aract management, congenital glaucoma, retinal blindness, and ge-netic disorders. Participants in the symposium are expected togain an understanding of the epidemiology of childhood blindness,recognize the leading causes of childhood blindness by region,and learn strategies to decrease the prevalence of preventableforms of childhood blindness.

139 An evidence-based update on myopia and interventions toretard its progression. Seo-Wei Leo, Terri L. Young

Myopia is the most common human eye disorder. With its in-creasing prevalence and earlier age-of-onset in recent birth co-horts, myopia now affects almost 33% of adult individuals in theUnited States, and epidemic proportions of 85%-90% adult individ-uals in Asian cities. In addition to the direct economic and socialburdens of myopia, associated ocular complications may lead tosubstantial visual loss. This workshop will summarize the current

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