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PubMed1979

Semiquantitative interference study of fatty layer of precorneal film.

Reflecting colours from the fatty layer of the precorneal film have been studied using mat filter (grease-proof paper, parchment paper, tracing paper) in front of the slit lamp mirror, maximally open light slit in a half-lit room, and magnification x 15. The palpebral fissure was narrowed until occurrence of red interference colour (2000 A). In 206 normal eyes the fatty layer was 102 +/- 3nm (+/- SEM), or about 0.1 micron, independent of age, sex and BUT (break up time). Maximum on awakening. Coefficient of variation 12.7 per cent. An increased fatty layer was noticed in cases of blepharitis (129 +/- 8 nm), in 91 per cent wearing hard contact lenses and 73 per cent wearing soft contact lenses. The fatty layer was likewise seen to be augmented in patients with acute infectious conjunctivitis (193 +/- 3 nm), chronic infectious conjunctivitis (164 +/- 7 nm), and in all states complicated by bacterial infection. The fatty layer is normal in allergic and chronic simple conjunctivitis. Silicone oil was found to effect reduction of the fatty layer.

Adipose Tissue↗
PubMed1996

Neutrophil-mediated suppression of virus replication after herpes simplex virus type 1 infection of the murine cornea.

Herpes simplex virus type 1 (HSV-1) infection of the murine cornea induces the rapid infiltration of neutrophils. We investigated whether these cells could influence virus replication. BALB/c mice treated with monoclonal antibody (MAb) RB6-8C5 experienced a profound depletion of neutrophils in the bloodstream, spleen, and cornea. In these animals, virus titers in the eye were significantly higher than those in the immunoglobulin G-treated controls at 3 days postinfection. By day 9, virus was no longer detectable in the controls, whereas titers of 10(3) to 10(6) PFU were still present in the neutrophil-depleted hosts. Furthermore, virus spread more readily to the skin and brains of MAb RB6-8C5-treated animals, rendering them significantly more susceptible to HSV-1-induced blepharitis and encephalitis. Only 25% of the treated animals survived, whereas all of the controls lived. Although MAb RB6-8C5 treatment did not alter the CD4+ T-cell, B-cell, natural killer cell, or macrophage populations, the CD8+ T-cell population was partially reduced. Therefore, the experiments were repeated in severe combined immunodeficiency mice, which lack CD8+ T cells. Again virus growth was found to be significantly elevated in the eyes, trigeminal ganglia, and brains of the MAb RB6-8C5-treated hosts. These results strongly indicate that in both immunocompetent and immunodeficient mice, neutrophils play a significant role in helping to control the replication and spread of HSV-1 after corneal infection.

Animals↗
PubMed1998

Persistence of herpes simplex virus type 1 DNA in chronic conjunctival and eyelid lesions of mice.

Herpes simplex virus type 1 (HSV-1) causes chronic blepharitis and conjunctivitis as well as keratitis in humans. The pathogenesis of these inflammatory ocular and dermal lesions is not well understood. We have examined the persistence of HSV-1 DNA and its relationship to inflammatory lesions in the conjunctiva and eyelid skin of mice which were inoculated with HSV-1 by the corneal route. Viral DNA was detected by in situ PCR in the conjunctiva and eyelid tissue of infected mice at 5, 11, 23, and 37 days postinfection (p.i.). This DNA was localized in the epithelial cells of the conjunctiva and hair follicles and in the epidermal cells of the eyelid skin. Viral proteins were not detected in the conjunctiva or the eyelid skin after 5 days p.i., even though histopathological lesions were found at 23 and 37 days p.i. in both tissues. The DNA-containing cells were adjacent to sites of inflammation in the chronic lesions in both the conjunctiva and the eyelid skin. A similar temporal and spatial relationship between HSV-1 DNA and inflammatory lesions has been previously reported for the cornea. Our data suggest that the lesions in the cornea, conjunctiva, and eyelid skin progress similarly. Further studies are required to determine whether the long-term presence of HSV-1 is involved in the mechanism by which these chronic inflammatory lesions develop. The presence of HSV-1 DNA in these extraocular tissues for extended periods may constitute persistent viral infection of nonneuronal cells.

Animals↗
PubMed1982

Aetiology and treatment of acute bacterial infection of the external eye.

The microbial flora of 738 patients with acute bacterial conjunctivitis, corneal ulceration, blepharitis, dacryocystitis, and discharging sockets has been investigated. Staphylococcus aureus, Streptococcus pneumoniae, and Haemophilus influenzae were the main pathogens isolated. Str. viridans was associated with conjunctivitis in patients aged under 1 year. moraxella sp. was isolated on only one occasion. Overall, 40% of specimens were associated with Staph. epidermidis or mixed skin flora, which also occurred with cultures of the normal eye. Clostridium welchii was isolated on 3 occasions but was not associated with bullae or gas gangrene. The least overall resistance, of 6%, was to chloramphenicol, but no one antibiotic was effective against all pathogens. Gentamicin remains the antibiotic of choice for Pseudomonas aeruginosa infection.

Acute Disease↗
PubMed1988

How do general practitioners manage eye disease in the community?

A survey of the management of eye disease in the community was carried out in two general practices over a three-month period. During this time there were 238 consultations by patients with ocular symptoms, making up 2.3% of all consultations and giving an annual consultation rate for eye disease of 66 per 1000 persons at risk. The four commonest diagnoses were bacterial conjunctivitis, allergic conjunctivitis, meibomian cyst, and blepharitis, and these accounted for more than 70% of the consultations. A variety of topical and systemic treatments were used, with topical chloramphenicol prescribed in 55% of consultations. Referral to a hospital eye department resulted from 35 consultations, giving a referral rate of 15% of all consultations.

Adolescent↗
PubMed1990

Effective antibody therapy in herpes simplex virus ocular infection. Characterization of recipient immune response.

The immunotherapeutic potential of a monoclonal antibody specific for glycoprotein D of herpes simplex virus was evaluated in a murine ocular infection model. Passive transfer of antibody at microgram concentrations was able to promote resolution of corneal opacity and hasten healing of blepharitis. Antibody treatment did not prevent development of either a cellular or humoral antiviral immune response. In fact, kinetic studies revealed that the early delayed-type hypersensitivity response was significantly more vigorous in the treated group than in the controls. Potential explanations as to how a single microgram inoculation of antibody could exert a therapeutic effect are discussed.

Animals↗
PubMed1992

Susceptibility of +/+, +/nu and nu/nu BALB/c mice to ocular herpes simplex virus infection.

Athymic (nude) mice have played an important role in defining the function of the immune system and its role in infectious diseases. In the majority of these studies, heterozygous +/nu mice have been used as normal controls for the nu/nu mice, and it has been assumed that +/nu mice have essentially normal immune systems. We have compared the response of +/+, +/nu and nu/nu BALB/c mice following ocular infection with HSV-1 and have found that +/nu mice develop significantly more severe blepharitis, vascularization of the cornea, stromal keratitis and extraocular disease (herpetiform spread) than +/+ BALB/c mice. The extraocular disease was particularly severe in the +/nu mice, suggesting that factors regulating herpetiform spread of the virus are deficient in these mice. Susceptibility to lethal encephalitis did not differ between +/+ and +/nu mice. These results suggest that significant differences exist in the response to ocular HSV infection between +/+ and +/nu mice.

Animals↗
PubMedDate not supplied

Lacrimal function and ocular complications in patients treated with systemic isotretinoin.

PURPOSE: To evaluate the effect on lacrimal function and ocular complications in patients with severe acne vulgaris during systemic treatment with 13-cis-retinoic acid (isotretinoin). METHODS: Forty patients with acne vulgaris were treated with systemic isotretinoin at dosages of 0.5-1 mg/kg per day for two months. Full ophthalmologic examination, Schirmer I test, fluorescein break-up (BUT) and microbiological investigations of the conjunctival flora were done before, during the second month and at least one month after the end of the treatment. RESULTS: The average Schirmer values before and after the treatment were 21.6 mm/5 minutes (SD +/- 7.01) and 18.48 mm/5 minutes (SD +/- 7.87) respectively. After the treatment BUT was less than 10 seconds in 50% of the patients and 55% had blepharitis. Subjective symptoms like dryness, itching and contact lens intolerance occurred in 42.5% and colonization of the conjunctiva by Staphylococcus aureus increased significantly during treatment (p= 0.031). All abnormal findings disappeared one month after the cessation of treatment. DISCUSSION: Isotretinoin causes signs and symptoms of dry eye, probably by reducing meibomian gland function, but ocular complications are generally not serious when low doses are used for a limited time, and are reversible after discontinuation.

Acne Vulgaris↗
PubMedDate not supplied

Efficacy of norfloxacin in bacterial conjunctivitis.

We investigated the efficacy and safety of norfloxacin 0.3% ophthalmic solution in 120 patients with bacterial conjunctivitis or blepharitis. Patients were selected for the study if they showed conjunctival hyperemia and at least three of the following criteria: a) symptoms of a surface ocular infection; b) a purulent discharge; c) crusting of the eyelids, and d) thickened, red lid margins. After taking a specimen for culture from the conjunctiva or skin-lash margin, the test drug was administered to the infected eye every two hours for one day, then 4 times daily for one week. Of the 120 patients who entered the study, 84.1% were cured. No serious adverse reactions occurred.

Adolescent↗
PubMedDate not supplied

Evaluation of efficacy and safety of ciprofloxacin ophthalmic solution versus chloramphenicol.

The results of this clinical study demonstrate that ciprofloxacin ophthalmic solution 0.3% is as safe and as effective as 0.5% chloramphenicol ophthalmic solution in the treatment of conjunctivitis and blepharitis of bacterial aetiology. Both agents achieved microbiological improvement rates in excess of 90% after 1 week's treatment. On ciprofloxacin 93.5% of patients were judged clinically cured or improved versus 84.6% on chloramphenicol after 1 week. There were no serious adverse affects. One patient in each group suffered drug-related side-effects (chemosis, erythema) which resolved on discontinuation or changing of therapy. Cirpofloxacin is not associated with the rare, but serious, side effect of aplastic anaemia which is associated with chloramphenicol use. On the evidence of this study ciprofloxacin would appear to be an appropriate agent for general use as a topical ophthalmic formulation.

Acute Disease↗
PubMed2004

Ophthalmologic features of Parkinson's disease.

Patients with Parkinson's disease (PD) commonly complain of impaired visual function and difficulty reading, despite normal visual acuity. Although previous studies have evaluated contrast sensitivity, color vision, visuospatial processing, visual hallucinations, and ocular movements, none has systematically evaluated the ocular complaints and ocular findings of PD patients. Thirty patients with early untreated PD and 31 control subjects without neurologic or known ocular diseases were ophthalmologically evaluated for the frequency of visual complaints, dry eyes, blepharitis, visual hallucinations, reduced blink rate, blepharospasm, and convergence insufficiency. Ocular complaints suggesting ocular surface irritation, altered tear film, visual hallucinations, blepharospasm, decreased blink rate, and decreased convergence amplitudes were more common in PD patients than in control subjects. These findings likely account for many of the visual difficulties commonly encountered by PD patients. These ocular abnormalities frequently respond to treatment.

Adult↗
PubMed2005

Spontaneous ophthalmic diseases in 586 New Zealand white rabbits.

The purpose of this study was to investigate spontaneous eye disease in New Zealand White (NZW) rabbits, which are commonly used for toxicity tests, and to provide reference materials for pharmaceutical companies and research centers. A total of 586 NZW rabbits were randomly chosen without sex preference and were examined using ocular equipment, including a direct ophthalmoscope, an indirect ophthalmoscope, a slit-lamp biomicroscope, a focal illuminator, and a fundus camera. This study showed that the incidence rate of temporary cataracts, regarded as a change within normal variation, was 0.5% in the NZW rabbits. Regarding abnormal ophthalmic disease, blepharitis was the most commonly observed ocular disease. Other findings included cataract, conjunctivitis, choroidal hypoplasia, keratitis, corneal scarring, eyelid laceration, posterior synechiae, uveitis, dacryocystitis, and persistent pupillary membrane. In total, the incidence rate of ophthalmic diseases was 9.6%. Based on sex and age distributions, females had more ocular diseases than males, and rabbits were less susceptible to eye diseases as they got older. In this study, photographs were taken to document findings, such as normal fundus, normal variations, ophthalmic disease, and histopathologic examination.

Animals↗
PubMed2003

Intracapsular lens removal in a Przewalski's wild horse (Equus caballus przewalskii).

A 11.5-yr-old female Przewalski's wild horse (Equus caballus przewalskii) presented for unilateral blepharitis and drainage from the left eye. The left cornea was not ulcerated, and intraocular evaluation was hampered by severe corneal edema. The left eye appeared to respond positively to treatment with anti-inflammatories and a topical mydriatic agent. During the ensuing 2 yr, there were minor episodes of epiphora from the left eye. The discharge then increased, and a luxated lens was noted during an examination by a veterinary ophthalmologist as part of the preshipment examination. Initially, the lens was located in the anterior compartment but was in the vitreal compartment at the time of surgery, complicating the intracapsular extraction. After successful removal of the lens, the horse was transferred to a new institution without incident, where it appears to have adapted well to its probable loss of vision in the left eye. No further episodes of uveitis, corneal edema, or epiphora have been reported, and the horse has successfully foaled at the new institution.

Animals↗
PubMed1981

Tobramycin in external eye disease: a double-masked study vs. gentamicin.

A double-masked randomized study was conducted at four centers to compare the efficacy and safety of tobramycin and gentamicin ophthalmic ointment in the treatment of superficial external eye disease. Seventy-seven patients with blepharitis and/or conjunctivitis were evaluated for safety, and 56 of the 77 individuals also qualified for evaluation of drug efficacy. After a 10 day treatment regimen, 97% of the tobramycin treated patients and 91.3% of the gentamicin treated patients were clinically cured or improved. Antibacterial effectiveness studies in the conjunctiva showed that tobramycin eradicated or controlled 87.8% of the bacterial infections vs. 77.4% for gentamicin. There was also a 9.3% adverse reaction rate with tobramycin vs. 17.6% with gentamicin. Primary symptoms consisted of erythema, injection, discomfort and itching. All adverse reactions were mild and cleared upon discontinuation of the study drug. While the trends seem to favor tobramycin, no difference was statistically significant at the p less than or equal to 0.05 level. These results indicate that tobramycin is a clinically effective and safe topical antibiotic and that it is comparable to gentamicin for topical treatment of bacterial external eye infections. It also may be better tolerated than gentamicin.

Anti-Bacterial Agents↗
PubMed1991

Ocular ulcerative herpes following measles in Kinshasa, Zaire.

Eight cases of ocular ulcerative herpes following measles are reported. The clinical features are characterized by dendritic corneal ulcer (6 cases) and ulcero-erosive blepharitis associated with corneal ulcer (2 cases). Bacteriologic examination disclosed Pseudomonas aeruginosas in 2 cases. The serum level of retinol, RBP, prealbumin and albumin were generally diminished in cases of dendritic corneal ulcer. These data are discussed in relation to the onset and severity of ocular ulcerative herpes associated with measles.

Blepharitis↗
PubMed1995

The effect of viral inoculum level and host age on disease incidence, disease severity, and mortality in a murine model of ocular HSV-1 infection.

It has been previously shown that the strain of virus, immune competence of the host, and innate resistance of the host have an effect on the severity of ocular disease induced by topical infection with herpes simplex virus type 1 (HSV-1). This study has expanded on earlier work by examining the effect of virus inoculum and host age on mortality, incidence of ocular disease, and severity of ocular disease. BALB/c mice were infected with inocula ranging from 2 x 10(3) to 1 x 10(6) pfu of HSV-1 strain CJ394. The most significant effect of variation in the inoculum was on the percent of mice developing disease. Increasing the inoculum resulted in significantly increased disease incidence, but at 5 x 10(3) pfu/mouse or higher, there was little difference in disease severity in those animals exhibiting symptoms. Decreasing host age also resulted in a significant increase in the incidence of ocular disease, but the dependence of disease severity on host age varied with the symptom being scored. In animals exhibiting disease, the peak severity of stromal keratitis and vascularization of the cornea were unaffected by host age. However, the severity of blepharitis was significantly reduced in older mice. Increasing host age also resulted in increased resistance to encephalitis. Three to four-week old mice were very susceptible to encephalitis (100% mortality), while only 20% of 4-5 week old mice died by day 15 post-infection. Mice older than 5 weeks were completely resistant to lethal encephalitis after corneal infection.

Aging↗
PubMedDate not supplied

Sterile peripheral keratitis following laser in situ keratomileusis.

BACKGROUND: Sterile infiltrates have been reported as a possible complication following photorefractive keratectomy (PRK). They have not been reported following laser in situ keratomileusis (LASIK). We review a case of fleeting, sterile peripheral corneal infiltrates following LASIK. METHODS: A 53 year old patient developed peripheral, sterile corneal infiltrates along the edge of the primary flap following LASIK. This was successfully managed with topical antibiotics and corticosteroids without permanent sequelae. RESULTS: Sterile peripheral corneal infiltrates are now a known complication following LASIK. Pathogenesis is undetermined but may involve activation of marginal keratitis reminiscent of that following blepharitis or a mechanism similar to acute subepithelial infiltrative keratitis following PRK. CONCLUSION: Fleeting, sterile peripheral corneal infiltrates can occur following LASIK. This undesired complication is poorly characterized but can be successfully managed with culturing of the infiltrates, topical corticosteroids, and antibiotics.

Anti-Bacterial Agents↗