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Eye health for kids

This August issue of Clinical and Experimental Ophthalmology includes two studies of surgical outcomes for quite different paediatric eye diseases. Landau Prat and colleagues report on the results of silicone sling frontalis suspension in a group of 174 children with myogenic congenital ptosis who were operated upon at The Children's Hospital of Philadelphia (Philadelphia, PA, United States). Hansen and co-workers present the biometric and refractive results of surgery for congenital or developmental cataract in 56 children who were treated at Rigshospitalet (Copenhagen, Denmark). With this editorial, our paediatric ophthalmology Section Editors are showcasing other interesting papers in their field that have appeared recently in the journal. Several basic science papers have focused on serious conditions that occur in young children. Lemaître and co-authors evaluated intravitreally injected chemotherapeutic agents for retinoblastoma in a genetically modified mouse model characterised by hereditary retinoblastoma. Their work suggested that intravitreal injections of carboplatin had strong activity against cancer, with acceptable toxicity. Zheng and team conducted bench research directed at a new treatment for advanced retinopathy of prematurity (ROP), using the mouse oxygen-induced retinopathy model, as well as several in vitro systems. This large body of work showed that a short peptide derived from human insulin-like growth factor 2—which they termed ‘CW-703’—was biologically active against experimental neovascularisation. Retinopathy of prematurity has been a nidus for paediatric ophthalmology study. Tram and team measured time reduction of physician workload for ROP screening before and after a nurse-led wide-field digital retinal imaging program was implemented at the Royal Women's Hospital in Victoria, Australia. There was a significant time reduction for image review with strategic in-person examinations (high risk and prior to discharge) and documentation, versus sole use of in-person examination and documentation. Koucheki and colleagues elucidated the natural history and outcomes of stage 3 ROP persisting beyond 40 weeks post-menstrual age and not meeting the Early Treatment for ROP (ETROP) criteria in 115 infants at the Hospital for Sick Children in Toronto, Canada. In this population, most infants' disease resolved spontaneously, with the main risk factors for poor structural outcome and thus consideration for treatment being more than 2 clock hours of persistent disease crossing the horizontal meridian— typically 9:00 position—and history of pre-plus disease. Region-specific medicine studies have been highlighted. Lee and co-workers reported on the rationale, methodology and baseline characteristics in a landmark randomised controlled trial evaluating the effect of low-dose atropine on myopia progression in a Western Australian population, the Western Australia Atropine for the Treatment of Myopia (WE-ATOM) study. Enrolment and randomisation to atropine 0.01% versus placebo were completed in 153 children from acrossWestern Australia to fill the dearth of scientific inquiry of atropine efficacy and safety in a more Western heterogeneous population than had previously been investigated. The data will be combined with two European studies (United Kingdom and Ireland) to provide a meta-analysis of Western populations' response to low-dose atropine. Smith and team provided regional recommendations for the management of juvenile idiopathic arthritis (JIA)-type chronic anterior uveitis. The Australian and New Zealand JIA-Uveitis Working Group comprised of 29 ophthalmologists contributed to Delphibased consensus statements. These regional recommendations join the recently published European, North American and United States consensus statements in an era of greater understanding of geographic and ethnic influence on disease. Maternal education was addressed by Staffieri and coauthors who shone a light on whether education about leukocoria and strabismus would translate into helpseeking intentions if these conditions were observed. Three hundred and eighty-two pregnant mothers living in Australia were given intervention or control educational brochures with preand post-testing. Maternal education yielded responses of being less likely to delay seeking medical advice, more with leukocoria than strabismus. Kaliki's article described the current management of aqueous seeding in intraocular retinoblastoma. This review emphasised the need for thorough assessment of Accepted: 6 July 2022