Arthur L. Rosenbaum

I. Strabismus Evaluation & Principles of Management: The Chief Complaint, History and Physical Examination, Understanding Sensory Evaluation, Tests of Muscle Function, Evaluation of Torsion and Principles of Management, Factors Influencing Measurement and Response to Surgery, Orbital Imaging in Strabismus Surgery, Clinical Applications of Computer Models for Strabismus. II. Horizontal Deviations: Infantile Esotropia Current Neurophysiologic Concepts, Selected Esotropia Entities Principles of Management, Serious Neurologic Disease Presenting as Comitant Esotropia, Divergence Palsy, Intermittent Exotropia, Selected Exotropia Entities and Principles of Management, Pattern Strabismus. III. Vertical Deviations: Superior Oblique Palsy and Superior Oblique Myokymia, Inferior Oblique Palsy Diagnosis and Management, Disassociated Vertical Deviation. IV. Other Paralytic Strabismus: Third Cranial Nerve Palsy Diagnosis and Management Strategies, Sixth Cranial Nerve Palsy, Monocular Elevation Deficiency & Depression Deficiency. V. Restrictive Strabismus: Strabismus Following Graves Ophthalmology, Strabismus Following Scleral Buckling & Glaucoma Implant Procedures, Strabismus Following Orbital Fracture & Sinus Surgery. VI. Selected Strabismus Syndromes: Duane Syndrome, Brown Syndrome, Moebius Syndrome, Congenital Fibrosis of the Extraocular Muscles, Strabismus Following Adult Cataract Surgery, Management of Selected Forms of Neurogenic Strabismus, Strabismus Associated with Craniosynostosis, Nystagmus Clinical Evaluation & Surgical Management. VII. Chemodenervation: Chemodenervation Therapy. VIII. Selected Surgical Complications & Procedures: Reoperating in Strabismus Strategies & Techniques, Slipped, Disinterred or Severed, and Lost Rectus Muscles, Other Selected Surgical Complications, Adjustable Suture (Fadenoperation), Inferior Oblique Weakening Procedures Techniques & Indications, Superior Oblique Procedures, Muscle Transposition Procedures, Anterior Ciliary Vessel Sparing Procedure

To test the efficacy and safety of vitamin E in preventing retinopathy of prematurity, 287 infants with birth weights of less than 1.5 kg or gestational ages of less than 33 weeks were enrolled within 24 hours of birth in a randomized, double-masked trial of IV, followed by oral, placebo v tocopherol (adjusted to plasma levels of 3 to 3.5 mg/dL). In the 196 infants completing ophthalmic follow-up, tocopherol did not prevent retinopathy of prematurity of any stage (28% placebo treated v 26% tocopherol treated) or moderately severe retinopathy of prematurity (8% placebo treated v 11% tocopherol treated). Cicatricial sequelae were not significantly different (1/97 placebo treated v 3/99 tocopherol treated), with one placebo-treated infant and one tocopherol-treated infant having retinal detachments. Among all 232 infants examined, those treated with tocopherol had more retinal hemorrhage than placebo-treated infants (8/121 placebo treated v 16/111 tocopherol treated), and retinal hemorrhage correlated positively (P less than .01) with plasma levels of tocopherol after the first 2 weeks of age. Prospective monitoring of morbidity including late-onset sepsis, necrotizing enterocolitis, etc revealed no differences between groups except that grades 3 and 4 intraventricular hemorrhage occurred more frequently in infants weighing less than 1 kg at birth who had received tocopherol (14/42, 33%) v those who had received placebo (4/43, 9%) (P less than .02). Our data do not support the use of tocopherol for prophylaxis against retinopathy of prematurity in premature infants and suggest that IV tocopherol treatment starting on day 1 may increase the incidence of hemorrhagic complications of prematurity, particularly in infants with birth weights of less than 1 kg.