Editorial
Taiwan J Ophthalmol 2017;7:1‑2
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An innovative era of pediatric
ophthalmology and strabismus
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P ediatric ophthalmology and
strabismus is the oldest subspecialty in
ophthalmology.[1] It is a constantly changing
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 10/04/2023
Website:
www.e-tjo.org and evolving field. Many new advances and
DOI:
current concepts are developed and need
10.4103/tjo.tjo_22_17 to be disseminated into the ophthalmic
community. This issue of Taiwan Journal
of Ophthalmology reflects the enthusiastic
dedication of pediatric ophthalmologists on
various interesting topics.
Duane syndrome is a common form
of congenital cranial dysinnervation
disorders (CCDDs). The term of CCDD
emerged from a multidisciplinary workshop
of clinicians and researchers who studied a
group of diseases characterized by abnormal
eye, eyelid, and/or facial movements.
The name reflects the finding that these
disorders result from development errors
in innervation of the ocular and facial
muscles. [2] Huber [3] classified Duane
syndrome into three types depending
on the pattern of horizontal movement
abnormality and electromyographic
findings. However, there are other forms
of abnormal innervation of extraocular
muscles which do not fit into Huber’s
classification. In this issue of Taiwan Journal
of Ophthalmology, Özkan [4] proposes
the addition of atypical forms of Duane
syndrome, including Type 4: synergic
divergence, Type 5: vertical retraction
syndrome, and Type 6: Y‑pattern deviation.
The clinical features of atypical forms of
Duane syndrome are demonstrated. This
article also presents a comprehensive
review of treatment options for Duane
syndrome. The advantages, disadvantages,
and indications for each treatment option
are discussed in details. The author warns
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that clinicians should be prepared for the
low predictability of surgical outcome
compared to conventional strabismus
surgery.
Cyclovertical strabismus has always been
a challenge to strabismologists. Among all
the surgical procedures, inferior oblique
muscle surgery is the most widely used
procedure for treating various vertical
or torsional strabismus. In this issue of
Taiwan Journal of Ophthalmology, Sato[5]
presents a concise historical review of
this procedure. The developments of
inferior oblique muscle surgery are listed
chronologically, from transcutaneous
approach in the 19th century to transposition
procedures nowadays. Although these
techniques have a long history for treating
cyclovertical deviations, the effectiveness
of these procedures is still controversial.
The interested readers can be referred
to a recent report by the same research
group, which reviewed the effectiveness
of simultaneous surgery of inferior oblique
myectomy and superior oblique tuck
for large angle of congenital/idiopathic
superior oblique palsy with a lax superior
oblique tendon.[6]
Managing a swollen optic disc in a child is
a crucial task to pediatric ophthalmologists
due to its potentially life‑threatening
implications. In this issue of Taiwan
Journal of Ophthalmology, McCafferty
et al.[7] present a clinical algorithm for the
evaluation of possible papilledema in the
pediatric patients. A workup guideline
at the University of Minnesota to clarify
etiology is described. The authors adopt
the revised diagnostic criteria proposed
by Friedman et al.[8] Friedman advocated
using the terms of primary and secondary
pseudotumor cerebri syndromes to avoid
How to cite this article: Tsai CB. An innovative era
of pediatric ophthalmology and strabismus. Taiwan J
Ophthalmol 2017;7:1-2.
1
 the self‑contradictory term like “secondary idiopathic
intracranial hypertension.” However, many clinicians
are used to the more simple division of primary and
secondary idiopathic intracranial hypertension proposed
by Aylward.[9] The consensus on nosology of this disease
is not well established yet.[10]
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With the rapid progress in diagnosis and management
of pediatric ophthalmology and strabismus, our
knowledge in this field is constantly revised. The
pathophysiological bases behind vision and ocular
nYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC1y0abggQZXdtwnfKZBYtws= on 10/04/2023
motility are continuously expanded. Increasing
treatment modalities have been developed to improve
the outcome. We are fortunate to participate and
witness the innovative era of this oldest subspecialty
of ophthalmology.
Chong-Bin Tsai
Department of Ophthalmology, Chiayi Christian Hospital,
Chia‑Yi City, Taiwan
Address for correspondence:
Dr. Chong‑Bin Tsai,
539, Jhongsiao Road, Chia‑Yi City,
60002 Taiwan, ROC.
E‑mail: 00687@cych.org.tw
2 Taiwan J Ophthalmol - Volume 7, Issue 1, January-March 2017
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