About

Julius Oatts, MD, MHS, is an Associate Professor of Ophthalmology at the Children's Hospital of Philadelphia within the Department of Ophthalmology. He specializes in pediatric ophthalmology, focusing on the medical and surgical management of children with eye conditions, with particular expertise in childhood glaucoma and anterior segment surgery, including innovative approaches to diagnosis and treatment. His research centers on evaluating novel diagnostic technologies for children with eye disease and detecting preventable childhood vision loss in low-resource settings both nationally and internationally. Dr. Oatts is also interested in the pediatric ophthalmology pathway and is a co-founder of the Pediatric Ophthalmology Mentorship program, aimed at fostering early interest in the field.

Research topics

• Medicine
• Ophthalmology
• Optometry
• Surgery
• Anesthesia

Selected publications

• Demographics and costs of pediatric blepharitis and conjunctivitis seen in California emergency departments over a 10-year period

  Journal of American Association for Pediatric Ophthalmology and Strabismus · 2026-03-09

  articleOpen accessSenior author
  PublisherOA PDFDOI

• A Virtual Reality Simulated Alternate Cover Test to Evaluate Adults with Strabismus

  Ophthalmology Science · 2026-01-18

  articleOpen accessSenior author

  <h2>Abstract</h2><h3>Objective</h3> Obtaining precise strabismus measurements is key in the diagnosis and management of strabismus in adults. Virtual reality (VR) has the potential to address the limitations of the standard alternate cover test (ACT) in measuring strabismus. The goal of this study was to evaluate the performance of a VR-simulated ACT in adults with strabismus. <h3>Design</h3> Prospective Cohort Study. <h3>Participants</h3> Eligible consecutive participants ≥18 years with manifest strabismus ≥5 prism diopters (PD) at either distance or near were prospectively enrolled. <h3>Intervention</h3> Each patient underwent a VR-simulated ACT with eye-tracking technology (Olleyes VisuALL) followed by an ACT by a masked pediatric ophthalmologist. Bland-Altman plots, intraclass correlation coefficient (ICC), and Spearman correlation were used to compare the limits of agreement (LOA) and association between the two exams for the entire cohort as well as those with deviations ≥10 PD. <h3>Main Outcome Measures</h3> Level of agreement between VR and standard strabismus measurements obtained from the VR and ACT. <h3>Results</h3> Of the 61 participants enrolled, 56 completed the VR test at near and 50 at distance. At distance, VR measurements were 0.88 prism diopters (PD) higher than the ACT (upper LOA: 19.3, lower LOA: -17.6). At near, VR measurements were 0.28 PD higher than the ACT (upper LOA: 26.1, lower LOA: -25.5). For patients with manifest strabismus ≥10 PD, VR measurements were 0.26 PD lower than the ACT at distance (upper LOA: 19.5, lower LOA: -20.1) and at 3.97 PD lower at near (upper LOA: 18.8, lower LOA: -2). Wider variability was observed in patients with larger deviations. Significant correlations between VR and ACT measurements were observed at distance greater than near (ICC=0.78, p<0.0001; ICC=0.57, p<0.001, respectively). Patients with deviations ≥10 PD exhibited similar agreement (ICC: 0.72, p<0.0001; near: ICC=0.64, p<0.0001). <h3>Conclusions</h3> A VR-simulated ACT demonstrated good correlation to standard strabismus measurements at distance and moderate correlation at near. The VR device underestimated deviations with larger deviations and tended to overestimate in those with smaller deviations. VR with eye-tracking technology holds promise in the assessment of adults with strabismus.

  PublisherOA PDFDOI

• Effectiveness of Corticosteroid-Sparing Topical Treatments for Vernal Keratoconjunctivitis in Children

  Ophthalmology · 2026-03-09

  article
  PublisherDOI

• Diagnostic Accuracy of a Retinal Birefringence Scanning Device Compared With a Traditional Autorefraction Device

  JAMA Ophthalmology · 2026-05-21

  article1st authorCorresponding

  Importance: Photoscreening devices are commonly used to identify children at risk for eye disease, although they often demonstrate low specificity as a trade-off for high sensitivity. A newly introduced photoscreening device that uses a newer mechanism, retinal birefringence scanning, purports to detect amblyopia and strabismus directly, and may theoretically increase specificity. Objective: To compare the diagnostic performance of 2 photoscreening devices, the Spot Vision Screener (Welch Allyn), hereafter referred to as a traditional autorefraction device, and the Blinq vision scanner (Rebion), hereafter referred to as a retinal birefringence scanner, for detecting amblyopia, strabismus, or visually significant refractive error (VSRE). Design, Setting, and Participants: This was a prospective, randomized, masked, diagnostic accuracy cohort study. The study included consecutive children 18 years or younger referred as a new patient to the University of California, San Francisco, pediatric ophthalmology clinic between January 2024 and February 2025 for suspected vision problems. Exposures: Each participant underwent screening with the traditional autorefraction device and the retinal birefringence scanner in randomized testing order, followed by a comprehensive eye examination. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for each device relative to the clinical reference standard. Main Outcomes and Measures: Sensitivity, specificity, and AUROC of both screening devices to detect amblyopia, strabismus, or VSRE. Results: Of 195 enrolled participants (median [IQR] age, 50 [25-66] months), 139 (mean [SD] age, 49.7 [35.6] months; 75 female [54.0%]) completed both photoscreening tests. The prevalence of amblyopia, strabismus, and VSRE was 15.1%, 32.4%, and 30.1%, respectively. The traditional autorefraction device demonstrated higher sensitivity than the retinal birefringence scanner for detecting amblyopia (29%; 95% CI, -2% to 50%; P = .03) and VSRE (41%; 95% CI, 17%-59%; P < .001), with no difference in sensitivity for detecting strabismus identified (-6%; 95% CI, -28% to 18%; P = .69). No differences in specificity were identified. Across all vision disorders, the AUROC for the retinal birefringence scanner was lower than that for the traditional autorefraction device, particularly for amblyopia (-0.13; 95% CI, -0.23 to -0.03; P = .01). Conclusions and Relevance: In this single-site diagnostic accuracy study, the traditional autorefraction device demonstrated greater overall diagnostic sensitivity than the retinal birefringence scanner for detecting amblyopia and refractive errors, with no difference in specificity for all conditions. These findings suggest that the traditional autorefraction device may be more reliable for comprehensive pediatric vision screening.

  PublisherDOI

• Strabismus surgery charges at ambulatory facilities across the United States

  Journal of American Association for Pediatric Ophthalmology and Strabismus · 2026-01-31

  article
  PublisherDOI

• Using selective laser trabeculoplasty to manage glaucoma in a child with phakomatosis pigmentovascularis

  American Journal of Ophthalmology Case Reports · 2026-03-07

  articleOpen access

  Purpose: To describe the management and complications associated with using selective laser trabeculoplasty (SLT) to treat elevated intraocular pressure (IOP) in a child with phakomatosis pigmentovascularis (PPV). Observations: ) gene, confirming a diagnosis of PPV. The right eye pre-treatment IOP was 33 mmHg and the patient was treated with 360-degree SLT. Two days later, she developed a shallow peripheral choroidal effusion in the right eye that resolved with medical management. Three months after SLT, the right eye IOP was successfully reduced to 19 mmHg after the discontinuation of acetazolamide. She maintained an IOP of 18 mmHg in the right eye 11 months after SLT on latanoprost and dorzolamide-timolol only. Conclusions and importance: Glaucoma filtering procedures in cases of PPV pose a high risk of complications and SLT offers a less-invasive, potentially clinic-based alternative. While the patient did develop a choroidal effusion post-SLT, suspected to be secondary to decreased IOP, this resolved with medical management alone without the need for incisional surgery thus illustrating both the risks and benefits of SLT in treating patients with phakomatoses-associated glaucoma.

  PublisherDOI

• Ophthalmologist and Optometrist Comanagement Model for Glaucoma: Outcomes from a Single Tertiary Care Health Center

  Ophthalmology Glaucoma · 2026-02-01

  articleOpen access

  PURPOSE: The growing demand for eye care poses significant challenges to the effective management of patients with glaucoma. This study evaluated long-term clinical outcomes of patients with glaucoma comanaged by institutionally trained optometrists and glaucoma specialists at the University of California San Francisco. DESIGN: Retrospective cohort study. PARTICIPANTS: Patients with glaucoma suspect or stable glaucoma diagnoses from 2016 to 2023. METHODS: Patients were comanaged by glaucoma specialists and optometrists with postgraduate institutional glaucoma-specific training via either "alternate care" (alternating glaucoma specialist and optometrist visits) or "transfer care" (optometrist visits only) for up to 5 years of follow-up. Generalized linear models were used to assess long-term changes in clinical parameters. MAIN OUTCOME MEASURES: Changes in intraocular pressure (IOP), best-corrected visual acuity (BCVA), medications, Humphrey visual field (HVF), and retinal nerve fiber layer (RNFL) thickness. RESULTS: The study included 391 patients (775 eyes), with 136 (34.8%) in alternate care and 255 (65.2%) in transfer care. The most common diagnoses were glaucoma suspect (51.2%) and primary open-angle glaucoma (POAG, 36.0%). No significant changes were observed in BCVA (P = 0.34), IOP (P = 0.18), medications (P = 0.11), or RNFL (P = 0.65) whereas the mean deviation of HVF improved (P = 0.003) over 5 years among both groups. Overall, 132 eyes (17.0%) required treatment escalation: 81 (10.5%) needed increased medications, 34 (4.4%) underwent glaucoma-related laser treatment, and 17 (2.2%) had incisional surgery. Among all eyes, 56 (14.3%) were rereferred to glaucoma specialists, with 43 (11.0%) returning to comanagement after evaluation or treatment. Alternate care patients saw both optometrists and glaucoma specialists at a median rate of once per year. Transfer care patients saw optometrists at a median rate of twice per year and none by glaucoma specialists. In multivariable analysis, escalation was associated with older age (odds ratio [OR], 1.30 per decade; 95% CI, 1.04-1.63; P = 0.02), POAG vs. suspect (OR, 2.99; 95% CI, 1.59-5.65; P < 0.001), and higher baseline IOP (OR, 1.18 per mmHg; 95% CI, 1.07-1.30; P = 0.01). Care pathway assignment was not significantly associated with treatment escalation. CONCLUSIONS: A well-defined and closely monitored comanagement model can maintain patient safety and glaucoma stability over 5 years with improved resource allocation and reduced utilization of glaucoma specialists. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

  PublisherDOI

• Reply

  Ophthalmology · 2025-11-14

  articleOpen access1st authorCorresponding
  PublisherOA PDFDOI

• Association of Childhood Neighborhood Opportunity With Retinopathy of Prematurity

  American Journal of Ophthalmology · 2025-07-16 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• Amblyopia screening: the current state and opportunities for optimization

  Expert Review of Medical Devices · 2025-01-02 · 3 citations

  reviewOpen accessSenior authorCorresponding

  INTRODUCTION: Amblyopia, the leading cause of monocular childhood vision loss, affects millions and is projected to increase. Early detection and treatment are crucial for preventing vision impairment. AREAS COVERED: This commentary reviews the current state and opportunities for improvement in amblyopia screening strategy and technology focused primarily within the United States. A review of current guidelines from organizations and a literature review of innovations between 1999 and 2024 informed this commentary. Organizations recommend routine vision screening for children, starting in infancy and continuing through adolescence. However, the variations in screening devices, components, timelines, and requirements leave room for improving outcomes. An exploration of instrument-based screening which has emerged as an alternative to traditional optotype testing will be investigated, and the risks of these instruments with high sensitivity and varying specificity will be acknowledged. Finally, new approaches to directly identify amblyopia and search for innovative biomarkers that indicate amblyopia risk or amblyopia itself will be discussed. EXPERT OPINION: Improving the treatment of amblyopia necessitates the reimagination of current practices in connecting patients to care. Technologies that incorporate novel diagnostic approaches, like the consideration of specific biomarkers or the use of artificial intelligence, hold promise to identify cases of amblyopia rather than its risk factors.

  PublisherOA PDFDOI

Recent grants

• Community-based amblyopia screening using a novel device

  NIH · $1.0M · 2025–2028

Frequent coauthors

• Ying Han

  University of California, San Francisco

  44 shared

• Yan Shi

  18 shared

• Ningli Wang

  Capital Medical University

  17 shared

• Yinxi Yu

  University of Pennsylvania

  16 shared

• Gui‐Shuang Ying

  University of Pennsylvania

  15 shared

• Mengya Zhao

  Changchun University of Chinese Medicine

  15 shared

• Jiaxin Tian

  Beijing Tongren Hospital

  14 shared

• Xin Chen

  11 shared

Labs

• OphthalmologyPI