076 Epidemiology and clinical characteristics of pediatric eyelid retraction. Jessica A. Olayanju, Gregory J. Griepentrog, Brian G. Mohney Introduction: Although eyelid retraction is a relatively rare form of eyelid malposition in children, there is no population-based data on this condition. The purpose of this study was to describe the inci- dence and clinical characteristics of eyelid retraction in children. Methods: The medical records of all pediatric patients ( \19 years) diagnosed with eyelid retraction from January 1, 1976, through December 31, 2010, at Olmsted County, Minnesota, were retrospec- tively reviewed. Results: A total of 62 were diagnosed during the study period, of which 15 were from a well-defined geographic region, yielding an annual incidence of approximately 1 in 77,519 patients younger than 19 years. The median, age at diagnosis was 11.5 years (range, 1 day to 18.72 years). Upper lid retraction occurred in 35 (56%) pa- tients, lower in 18 (29%) patients, and both upper and lower retraction in 9 (15%) patients. The most common causes of lid retraction were thyroid eye disease (40%), trauma (15%), and congenital lid retraction (10%). While symptoms including tearing, ocular surface irritation and photophobia were noted in 24 (38%) patients, there were no documented cases of visual impairment secondary to eyelid retrac- tion. Seventeen (27%) of the 62 patients required surgical interven- tion with 94% improvement. Discussion: In this 35 year cohort of pediatric eyelid retraction, approximately two-thirds were due to thyroid eye disease, trauma, or congenital eyelid retraction. No visual disturbances were noted and only 1 in 4 patients required corrective surgery. Conclusions: Pediatric eyelid retraction is a rare condition that is most likely associated with a thyroid disorder and no visual abnorma- lities. 077 A tool for evaluating ergonomic posture during strabismus surgery. Scott E. Olitsky, Melanie Simmer-Beck, Bonnie S. Branson Introduction: Surveys have shown that the incidence of musculo- skeletal disorders (MSD) is high among ophthalmologists. The cause of these disorders is thought to be secondary to poor ergonomic posture in both the clinic and the operating room. The incidence of MSD among dentists is considered to be even higher and the dental field has taken steps to identify high risk activities and attempt to modify the work environment in order to reduce this risk. Recently, an evaluation tool has been shown to be useful in identifying dental operator postures that can be harmful. This study looked at utilizing a similar tool to evaluate strabismus surgeons. Methods: Strabismus surgeons were monitored during surgery and their posture was evaluated using a tool established for examining dentists during operative procedures. The testing process was compared to similar evaluations made during dental procedures. Results: The evaluation process was found to be similar for the postural assessment of strabismus surgeons during surgery to that used to examine dentists. Discussion: Neck and back pain are common disorders among oph- thalmologists. Identifying postural habits that are ergonomically un- sound can help to reduce the risk of these problems. A previously designed dental tool can be modified to allow evaluation of postures seen during strabismus surgery. Conclusions: An evaluation tool which has been modified for dental use may be able to help identify unsafe operating postures seen dur- ing strabismus surgery and suggest operating positions and tech- niques that would be safer for the surgeon performing strabismus surgery. 078 Fluorescein angiography versus fundus photography on the diagnosis and management of retinopathy of prematurity. Samir N. Patel, Michael A. Klufas, Michael C. Ryan, Karyn E. Jonas, Susan Ostmo, Audina M. Berrocal, Michael F. Chiang, R. V. Paul Chan Introduction: Fluorescein angiography (FA) is an imaging modality that may provide useful information regarding the retinal vasculature in the premature retina; however, little information exists on the utility of FA in patients with retinopathy of prematurity (ROP). The purpose of this study is to (1) examine and compare how fundus photography and FA influence the identification of the fovea in ROP and (2) eval- uate the influence of FA on the diagnosis and management of ROP. Methods: 32 sets (16 fundus photographs; 16 fundus photographs paired with corresponding FAs) of wide-angle retinal images ob- tained from 16 eyes of eight infants with ROP were compiled on a secure web site. 9 ophthalmologists (3 pediatric ophthalmologists; 6 vitreoretinal surgeons), with experience in ROP diagnosis and man- agement, interpreted each image set, identified the fovea, and pro- vided a diagnosis of zone, stage, plus, and category. Sensitivity and specificity was calculated using a consensus diagnosis, deter- mined from diagnosis of the color fundus images by three indepen- dent readers in combination with the ophthalmoscopic examination. Results: A computer-generated diagnosis of zone based on a sub- jects identification of fovea agreed with that subjects diagnosis of zone in 3.1 of 5 (62%) cases using fundus photographs and in 3.4 of 5 (68%) cases using FA. When interpreting fundus photography alone versus fundus photography and FA, mean sensitivity improves for detection of stage 3 or worse disease (39.8 to 74.1), zone I (47.2 to 61.1), type 2 or worse disease (69.4 to 86.8) and treatment requiring disease (22.2 to 40.3). Using the kappa statistic, inter-grader agree- ment for identification of treatment-requiring ROP improved signifi- cantly when viewing the fundus photographs + FA as compared to viewing the fundus photographs alone. Discussion: There is variability between identification of the macular center and concordance with the subjective diagnosis of zone. FA supplementation can improve sensitivity for certain subtypes of ROP zone, stage and category as well as increasing intergrader agreement for treatment-requiring ROP. Conclusions: FA continues to have an evolving role in the diagnosis and management of ROP. FA may be most helpful in determining zone I ROP. 079 Severe corneal complications in children with blepharitis. Diyaa Rachdan, M. Saad Khan, Asim Ali, Kamiar Mireskandari Introduction: Blepharitis is a chronic inflammation of lid margins that can lead to spectrum of ocular surface involvement such as phlycte- nules, neovascularization, lipid deposits, scarring and irregular astig- matism. In children, these may compromise visual acuity and lead to amblyopia (1,2). In this study we report the visual outcome and corneal complications in pediatric blepharitis. Methods: Records of all children with blepharitis seen between 2006-13 were reviewed. Inclusion criteria were corneal lesions due to blepharitis (new vessels, inflammation, opacity, thinning, or lipid deposits) and follow-up of $6 months. Other ocular pathol- ogies that might affect vision were excluded. Initial and final BCVA, medications and surgical procedures were recorded. Results: We identified 123 patients with mean age of 8.0 years (0.8- 17.3) and follow-up of 30.4 months. Central pathology was present in 35% of all eyes and 60% of patients needed systemic antibiotics. Final visual acuity worse than 20/40 was associated with requiring corneal surgery (OR 5 4.69), presence of central pathology (OR; Journal of AAPOS e30 Volume 19 Number 4 / August 2015