Derek T Sprunger

Indiana University School of Medicine | IUSOM · Department of Ophthalmology

Introduction Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia. Methods Global responses to a questionnaire were analysed (n=794)...

Importance: The US Food and Drug Administration's medical device regulatory pathway was initially conceived with hardware devices in mind. The emerging market for ophthalmic digital devices necessitates an evolution of this paradigm. Objectives: To facilitate innovation in ophthalmic digital health with attention to safety and effectiveness. Ev...

Purpose: To explore what the current worldwide preferred practice patterns of pediatric ophthalmologists are to decrease myopia progression among their patients. Methods: A questionnaire was sent to all members of supranational and national pediatric ophthalmology and strabismus societies. Results: The questionnaire was fully completed by most...

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Purpose: To compare the effectiveness of intermittent occlusion therapy (IO therapy) using liquid crystal glasses and continuous occlusion therapy using traditional adhesive patches for treating amblyopia. Methods: Children 3-8 years of age with previously untreated, moderate, unilateral amblyopia (visual acuity of 20/40 to 20/100 in the amblyop...

Purpose: To evaluate the results of vertical muscle transposition with augmentation in cases of exotropia caused by iatrogenic lost medial rectus muscle. Methods: This is a retrospective review of 5 cases of lost medial rectus with exotropia and marked limitation of adduction that underwent surgery. All cases had a history of strabismus surgery...

Pediatric optic neuritis is an uncommon disorder with significant distinctions from its adult counterpart. Recognizing the features of this disorder and the potential association with progressive demyelinating processes is important for patients' evaluation and prognosis. In the last few years, studies have expanded our understanding of demographic...

Many patients describe more rapid recognition of objects after surgical procedures for nystagmus; however, this "recognition time" is not reflected in the parameters typically studied in these patients. The purpose of this study is to assess the effect of nystagmus surgery on visual acuity and recognition time. In this prospective, interventional,...

Retinal vascular changes and the development of plus disease are the hallmarks of retinopathy of prematurity (ROP). The purpose of this study was to evaluate whether or not serial examinations of retrobulbar blood flow characteristics, as measured by color Doppler imaging (CDI) performed repeatedly over a period of several weeks, would be useful fo...

Occlusion, pharmacologic pernalization and combined therapy have been documented in controlled studies to effectively treat amblyopia with few complications. However, there remain concerns about the effectiveness and complications when, as in this case, there are not standardized treatment protocols. A retrospective chart review of 133 consecutive...

Objective: To determine whether earlier treatment using ablation of the avascular retina in high-risk prethreshold retinopathy of prematurity (ROP) results in improved grating visual acuity and retinal structural outcomes compared with conventional treatment. Methods: Infants with bilateral high-risk prethreshold ROP (n=317) had one eye randomized...

Objective: To compare patching and atropine as treatments for moderate amblyopia in children younger than 7 years. Methods: In a randomized clinical trial, 419 children younger than 7 years with amblyopia and visual acuity in the range of 20/40 to 20/100 were assigned to receive either patching or atropine at 47 clinical sites. Main Outcome Measure...

The optimal role of intraocular lenses (IOLs) in infants remains a controversial topic for many reasons, including concerns about significant complications occurring in young rapidly developing eyes. To assess the number and type of significant complications requiring further intervention occurring in the first postoperative year, we reviewed the r...

To compare various materials used in frontalis suspension surgery for incidence of infection and/or granuloma formation and incidence of recurrent ptosis. A retrospective medical record analysis was performed for 102 frontalis suspension operations performed on 43 patients between January 1, 1991, and December 31, 1996, at Indiana University Medica...

Congenital esotropia is often associated with congenital nystagmus. This study examines the relationship between the presence of nystagmus and surgical outcome in the treatment of patients with congenital esotropia. In this institutional retrospective study, we reviewed the charts of 200 consecutive patients who underwent surgical correction for co...

Objective: To determine the efficacy and safety of supplemental therapeutic oxygen for infants with prethreshold retinopathy of prematurity (ROP) to reduce the probability of progression to threshold ROP and the need for peripheral retinal ablation. Methods: Premature infants with confirmed prethreshold ROP in at least 1 eye and median pulse oxi...

Nystagmus continues to be a complex subject of study. Our ability to characterize nystagmus has improved, but our comprehension of the oculomotor control process underlying this condition remains vague. We review recent advances in the characterization, classification, and treatment of nystagmus. Congenital forms of nystagmus, nystagmus associated...

This report is a summary of the data of the IOLAB, Inc pediatric intraocular lens (IOL) implantation investigation. The goal of this study was to evaluate the safety and efficacy of IOL implantation for the treatment of pediatric aphakia, pending approval by the Food and Drug Administration. From May 1981 to July 1994, a total of 1260 pediatric eye...

To determine the long-term motor and sensory results after early surgical correction of patients with congenital esotropia. Noncomparative interventional case series. Ten infants with congenital esotropia. Patients had bimedial rectus recession between 83 and 159 days of age; were re-examined in a regular follow-up program; and were retreated when...

Purpose: This report is a summary of the data of the IOLAB, Inc pediatric intraocular lens (IOL) implantation investigation. The goal of this study was to evaluate the safety and efficacy of IOL implantation for the treatment of pediatric aphakia, pending approval by the Food and Drug Administration. Methods: From May 1981 to July 1994, a total of...

VLBW children are known to have a high frequency of early onset strabismus, which is related to the high prevalence of pre- and perinatal cerebral disturbances reported in these children. It is unknown if the early onset strabismus in VLBW children has the characteristics of infantile esotropia. If so, then (acquired) cerebral damage may play an im...

We studied the natural history of pure refractive accommodative esotropia after spectacle correction in patients with onset before 1 year old to determine whether their outcomes and characteristics were different from those of patients with more typical age at onset of refractive accommodative esotropia. We retrospectively reviewed the charts of 17...

To determine whether 5-fluorouracil is effective in reducing scarring after strabismus surgery we used rectus muscle surgery in experimental animals to compare a single intraoperative dose of 5-fluorouracil with mitomycin C and to compare results in similarly treated controls not receiving these antimetabolites. Muscle resections were performed on...

Screening examinations for retinopathy of prematurity (ROP) can be stressful to the premature infant. The temporal retina is the most easily visualized area of the peripheral retina. This study was undertaken to determine whether evaluation of the temporal peripheral retina provides a reliable indicator of the ROP status of the entire retina. A tot...

Guidelines for intraocular lens (IOL) implantation in children regarding patient selection, age limitations, operative techniques, including management of the posterior capsule, and refractive goals are not universally agreed on. The authors placed posterior chamber IOLs in the capsular bag of 79 eyes in 57 children. Patient age ranged from 10 mont...

The purpose of the study is to describe the clinical characteristics and surgical management of strabismus associated with chronic progressive external ophthalmoplegia. The authors present four patients with chronic progressive external ophthalmoplegia and strabismus requiring extraocular muscle surgery, with attention to presenting symptoms, patte...

Duane syndrome is characterized by abduction deficiency, narrowing of the palpebral fissure on adduction, and globe retraction,which can be the most prominent aspect of the motility disorder. Recession of both horizontal rectus muscles was investigated for treatment of severe globe retraction. Three patients with Duane syndrome were operated on for...

Reports of several large series of patients with superior oblique palsy (SOP) published in 1986 or before set forth important guidelines for both diagnosis and treatment of this condition. Newer information about the anatomy, physiology, and pathophysiology of the superior oblique has accrued over the past decade. This paper reviews our experience...

Large recession of the four horizontal rectus muscles has been shown at best to minimally improve visual acuity as measured with Snellen letters. However, many patients have reported a dramatic improvement in ability to recognize objects more quickly after large recession of the horizontal recti. We used a shutter device to measure the time it took...

Comitant strabismus has been investigated and treated for centuries. Advances in understanding the etiology of this disorder have improved our ability to successfully treat it. This article addresses recent insights into the causes and treatments of comitant strabismus, with a focus on congenital esotropia, intermittent exotropia, and adult strabis...

The incidence of potentially vision-threatening globe perforation during strabismus surgery is reportedly between less than 1% and 12% of cases. Optimal treatment of globe perforation is not known; however, traditionally it has been treated with cryotherapy at the time of surgery or observation without treatment. The indirect-ophthalmoscope-directe...

Background:The incidence of potentially vision-threatening globe perforation during strabismus surgery is reportedly between less than 1% and 12% of cases. Optimal treatment of globe perforation is not known; however, traditionally it has been treated with cryotherapy at the time of surgery or observation without treatment. The indirect-ophthalmosc...

Purpose: Two years ago we presented short-term (∼2 mos) oculographic follow-up for 8 patients who had undergone arge horizontal rectus muscle recessions for the treatment of nystagmus. The time when the eyes were fixating within ±0.5° of the target improved in 8/8 patients; the average slow phase velocity during this period improved in 6/8. Modest...

Reports of several large series of patients with superior oblique palsy (SOP) published in 1986 or before set forth important guidelines for both diagnosis and treatment of this condition. Newer information about the anatomy, physiology, and pathophysiology of the superior oblique has accrued over the past decade. This paper reviews our experience...

Because hand steadiness is an important aspect of microsurgical technique, hand movement, amplified by a hand-held laser pointer, was measured in 14 ophthalmology trainees on four separate mornings when each had ingested (1) 200mg of caffeine, (2) 12.5mg of timolol (2.5mL of timolol 0.5% ophthalmic solution), (3) a combination of caffeine and the b...

We reviewed 67 cases of inferior rectus muscle recession. In 14 cases, the hypotropia was corrected to a satisfactory alignment in the immediate postoperative period followed by a progressive overcorrection (hypertropia). Patients with thyroid eye disease were at highest risk for progressive overcorrection, as 9 of 18 (50%) developed the problem. P...

Surgical treatment for Brown superior oblique tendon sheath syndrome, now called Brown syndrome, has been advocated for patients with abnormal head posture or manifest hypotropia in primary gaze. Several surgical procedures with variable results and complications have been reported without consensus. Techniques and results of treatment for Brown sy...

Retroequatorial recessions of the horizontal rectus muscles 10 to 12 mm behind their insertions reduced the amplitude of manifest congenital nystagmus in three patients. Modest improvement of visual acuity occurred in two patients. In a third patient with periodic alternating nystagmus, a compensatory head turn was eliminated by shifting the neutra...