ings. This supports the argument that there may be no patho-gnomonic eye signs in shaken baby syndrome.

Pediatric ocular myasthenia gravis. Steven Ortiz, MarkBorchertIntroduction: Pediatric ocular myasthenia gravis (MG) is anuncommon condition that mimics common problems encoun-tered by the ophthalmologist. The course and outcomes of thisdisorder have not been well reported. The purpose of this studywas to review the presentation, course, and treatment of pediatricocular MG. Methods: The medical records of children less than12 years old presenting with ocular MG and having at least 2years of follow-up at the Children’s Hospital of Los Angeles eyeclinic were reviewed retrospectively. Data collected included ageof onset of symptoms, presenting signs, medical and surgicaltreatments, and outcomes, including systemic generalization andpartial or complete resolution. Results: ‘X’ patients with a meanage of onset of symptoms at 22 months were included. The initialpresenting sign was ptosis in 77%, strabismus in 55%, withexotropia most frequently. Systemic generalization occurred in10% and resolution of symptoms occurred in 14%. Strabismussurgery was required in 25% and ptosis repair in 8%. Conclu-sions: This series of children with ocular MG contains thelargest reported cohort of patients with this uncommon disorder.These findings will help elucidate the outcomes of the conditionto help in the diagnosis, therapy, and counseling of children withocular MG.

Monocanalicular versus bicanalicular silicone tubeintubation for congenital nasolacrimal duct obstruction.Gregory Ostrow, Srinivas E. Iyengar, Scott E. Olitsky, MerrillStass-Isern, Denise Hug, Laura P. SmithIntroduction: Both monocanalicular and bicanalicular siliconetube intubation are useful in the treatment of congenital naso-lacrimal duct obstruction. Monocanalicular intubation is lesstraumatic, less time consuming, and does not potentially requiregeneral anesthesia for removal of the tube. If the outcomes ofmonocanalicular intubation are similar to bicanalicular intuba-tion, it may be a preferable procedure. Methods: The records ofall patients that underwent silicone tube intubation for congen-ital nasolacrimal duct obstruction at Children’s Mercy Hospitalbetween January 2000 and July 2006 were reviewed. Successfultreatment was defined as a lack of tearing or mattering followingat least one postoperative visit and at the most recent visit.Patients were excluded if they had prior intubation of the naso-lacrimal system. Results: One hundred fifty-five total eyes metthe inclusion criteria (41 bicanalicular intubations and 85 mono-canalicular intubations). Twenty-nine of 41 (70.7%) bicanalicu-lar intubations and 69/85 (81.2%) of monocanalicular intuba-tions were successful. These results were not statistically differ-ent with an absolute risk reduction (ARR) of �0.048 to 0.258(CI, 95%). When intubation was the primary treatment proce-dure, 7/12 (58.3%) bicanalicular and 14/15 (93.3%) were suc-cessful. This was significant with an ARR of 0.0631-0.636 (CI,95%). Conclusions: Monocanalicular intubation for congenitalnasolacrimal duct obstruction is as successful as bicanalicularintubation and may be superior as a primary procedure. Mono-canalicular intubation is less time consuming, less invasive, anddoes not potentially require sedation for removal. Monocanal-icular intubation may be a preferable procedure in the treatmentof uncomplicated congenital nasolacrimal duct obstruction.

ROP outcomes in the post-ETROP era. Manoj V.Parulekar, Steve Conti, Wai Ching Lam, Nasrin NajmTehraniIntroduction: This retrospective study compared outcomes oflaser treatment for ROP in a large tertiary referral center beforeand after adopting recommendations from the Early Treatmentfor Retinopathy of Prematurity (ETROP) trial. Methods: Ninety-two consecutive infants treated with laser for ROP at our unitfrom 2001 to 2006 were included. The anatomical and functionalresults in both groups in the 3 years prior to adopting theETROP criteria were compared with our results in the 2 yearsfollowing implementation of the ETROP recommendations.Results: Analysis by �2 was performed on outcome measures forboth groups. There was an increase in the number of babiestreated, with a significant improvement in anatomical outcomeswith earlier treatment. There was a trend toward referral earlierin the course of disease from referring NICUs to our unit fortreatment, and a significant increase in the number of laser spots,reflecting more confluent laser treatment in the post-ETROPperiod. Discussion: While the number of laser episodes hasincreased as a result of treating earlier in the course of disease,there has been a significant reduction in the need for subsequentsurgical interventions for retinal detachment. Conclusions: Ear-lier referral and treatment for ROP, restructuring of the ROPservice in our department, and utilization of digital imagingfollowing implementation of ETROP guidelines has resulted infewer surgical interventions and better outcomes.

Quality of life in intermittent exotropia. Christine J. Powell,Deborah Buck, Michael P. Clarke, Sarah R. HattIntroduction: This study assesses the impact of intermittentexotropia on health related quality of life (HRQoL) from parentand child perspectives using the PedsQL questionnaire. Method:The PedsQL rates HRQoL on four scales: physical (PF), emo-tional (EF), social (SF), and school (SchF) functioning. Parentsand children �5 years completed a questionnaire as part of aprospective data collection exercise: the UK Improving Out-comes in Intermittent Exotropia study. Results: One hundredforty questionnaires were analyzed ( parent, n � 70; child, n �70). Children with intermittent exotropia scored their QoLlower than “healthy” children in a published sample on PF, SF,and SchF scales (one-sample t-test, t � �4.45 to �5.02, p �0.001). Study parents rated their child’s QoL worse than theparents of the “healthy” population only in EF (one-samplet-test, t � �5.21, p � 0.001). Study data show poor correlationbetween parent and child scores on all four individual scales andtotal HRQoL score(Pearson’s product moment, r � 0.01-0.13).Discussion: Children with intermittent exotropia report a rangeof problems with HRQoL. These are different from the prob-lems perceived by the parents. This may relate to the severity ofthe condition. Conclusion: HRQoL data are a useful adjunct inassessing the impact of intermittent exotropia and in planningsurgery for this condition.

The ocular motor questionnaire study. Leah G. Reznick,Richard W. HertleIntroduction: To test the reliability of this ocular motor ques-tionnaire as a tool to quantify visual function in patients withstrabismus and nystagmus, and to determine how this measure ofvisual function is effected by treatment of patients with ocularmotor disorders. Methods: This study was a prospective caseseries that includes 100 children and adults with strabismus

Volume 11 Number 1 February 2007100 Abstracts

Journal of AAPOS