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PubMed1998

Development and use of nested polymerase chain reaction (PCR) for the detection of adenovirus from conjunctivitis specimens.

BACKGROUND: The standard virus isolation method for detecting adenovirus is time consuming and direct detection of viral antigens in smears has its limitations. Therefore a rapid and a reliable method to identify virus in clinical specimens is desirable. OBJECTIVE: To develop and evaluate nested PCR as a tool for detecting adenovirus from conjunctival swabs of patients with acute conjunctivitis during an epidemic. STUDY DESIGN: A total of 201 patients with acute conjunctivitis were seen between August and November 1996. Conjunctival swabs from the most recently affected eyes were collected from 20 random patients and processed for antigen detection in direct smears, for adenovirus, enterovirus (EV70) and coxsackievirus A24 variant and adenovirus isolation by culture. Nested PCR was performed using oligonucleotides to amplify 1004 basepair (bp) and 956 bp fragments of DNA coding for adenovirus hexon protein. The neutralisation test, to type the adenovirus, was done on four isolates selected at random. RESULTS: The PCR could detect 0.0032 fg of adenovirus DNA (corresponding to 8.3 x 10(-3) adenovirus particles). The EV70 and coxsackievirus A24 antigens were not detected. The specimens were positive for adenovirus by all three techniques in seven patients: (a) by direct smear and PCR in 2; (b) by virus isolation and PCR in 2; and (c) by PCR alone in five patients. In one patient the direct smear alone was positive. The PCR required 3 days to detect the virus, antigen detection provided diagnosis the same day and virus isolation required 8-27 days. A total of four isolates selected at random were identified as serotype 7a. CONCLUSION: The nested PCR is a reliable and rapid technique for detection of adenovirus from conjunctival swabs. The adenovirus serotype 7a was the likely causative agent of this epidemic conjunctivitis.

Acute Disease↗
PubMed2002

Treatment of acute neonatal bacterial conjunctivitis: a comparison of fucidic acid to chloramphenicol eye drops.

PURPOSE: To compare the clinical and bacteriological effects of fucidic acid (Fucithalmic: 1.0%) and chloramphenicol (Minims(R): 0.5%) eye drops in neonates with a clinical diagnosis of acute conjunctivitis of suspected bacterial origin. METHODS: A TOTAL OF 456 N: ewborns with gestational age > 32 weeks with acute conjunctivitis of suspected bacterial origin acquired within the first 28 days of life were included in the study. They were randomly assigned to a 7-day treatment with eye drops using either fucidic acid (1.0%) (Fucithalmic) applied twice per day, or chloramphenicol (0.5%) (Minims Chloramphenicol) applied six times per day. The subjects were followed up with two visits (on days 1 and 8) and by telephone 2 weeks after the end of treatment. RESULTS: Eighty-nine per cent of the neonates treated with Fucithalmic were cured, compared to 87.9% of those treated with Minims Chloramphenicol (n.s). The drug was used as instructed in 90.7% of patients treated with Fucithalmic and in 78.0% of those treated with Minims Chloramphenicol (P < 0.001). CONCLUSION: Treating neonatal conjunctivitis with fucidic acid is easier than with chloramphenicol and is equally effective.

Acute Disease↗
PubMed2001

Feline eosinophilic conjunctivitis.

OBJECTIVE: To review 12 cases of histologically confirmed feline eosinophilic conjunctivitis, their clinical, cytologic, histologic and electronmicroscopic findings, results on PCR for FeHV-1, treatment and outcome. ANIMALS STUDIED: Twelve naturally occurring cases presented during a period of 26 months. PROCEDURES: Thorough ophthalmologic examination, conjunctival scrapings performed with the cytobrush method; histologic samples from the palpebral conjunctiva; PCR for FeHV-1 on Schirmer Tear Test (STT) strips; saliva and nasal swabs, and retrospective evaluation of all results. RESULTS: The breed most commonly affected was the Domestic Shorthair (n = 8), followed by Persians (n = 2), Somali (n = 1) and Siamese (n = 1). Age at presentation was 1-15 years with a mean age of 7.2 years. Nine cats were castrated males; three cats were females: two of them were spayed. Unilateral (n = 7) or bilateral (n = 5) involvement with depigmentation and erosions of lid margin, blepharospasm, swelling and redness of conjunctiva and third eyelid were the most common clinical findings. Frequency of eosinophils in cytologic samples was more than 10% in every patient. PCR for FeHV-1 on STT was negative in all cases. Histologically, eosinophils, lymphocytes, plasma cells, mast cells and macrophages were involved. On electronmicroscopy, viral particles were not detected. Ten cases needed long-term anti-inflammatory treatment. CONCLUSIONS: The 12 reviewed cases suggest that feline eosinophilic conjunctivitis is a chronic inflammatory uni- or bilateral disease of the adult cat. Typically the lid margin was also involved, and was thickened, depigmented and erosive. Cytological examination of conjunctival scrapings was a valuable tool for detecting eosinophilic conjunctivitis. The cytological findings correlated well with the histopathological findings in our patients. Topical or systemic anti-inflammatory drugs resolved the clinical symptoms in our cases within a short period of time. Neither electronmicroscopy nor PCR were able to detect involvement of FHV1 in the represented cases. The etiopathogenic role of FeHV-1 remains undetermined.

Animals↗
PubMed1985

[Differential diagnosis and therapy of gigantopapillary conjunctivitis].

If wearers of contact lenses present with secretion and incompatibility of the contact lens, simple ectropionation of the upper eyelids often is sufficient to diagnose a giant papillary conjunctivitis as the cause. This form of papillary hypertrophy affecting wearers of both hard and soft contact lenses is morphologically similar to vernal conjunctivitis, which should be considered in cases of corneal ulceration resistant to therapy. The histological difference between the two forms of papillary hypertrophy is that contact lens-induced giant papillary conjunctivitis shows remarkably less eosinophilic infiltration of the papillary stroma. Both forms of papillary hypertrophy seem to be based on a complex immunologic reaction.

Adult↗
PubMed2000

Ligneous conjunctivitis: a local manifestation of a systemic disorder?

Ligneous conjunctivitis is a descriptive term. It refers to the "woody" consistency of the pseudomembrane that usually forms on the palpebral conjunctiva of those affected. It is rare and probably only one manifestation of a multiorgan, pseudomembranous disease. (1-4) We report a case of ligneous conjunctivitis in which investigation revealed a plasminogen deficiency in the heterozygous range (previously reported only in association with a homozygous plasminogen deficiency). We suggest a strategy for investigating known and new cases of ligneous conjunctivitis and/or pseudomembranous disease.

Biopsy↗
PubMed2001

Delayed tear clearance in contact lens associated papillary conjunctivitis.

PURPOSE: To study the tear film clearance in contact lens associated papillary conjunctivitis patients. METHODS: Fifty-eight daily-wear soft contact lens wearers completed a questionnaire regarding a survey of their contact lens usage and subjective symptoms. They were grouped according to the size of conjunctival papillae, namely PC1 with no papillae, PC2 with papillae of less than 0.3 mm, and PC3 with papillae of 0.3-1.0 mm in diameter. Tear film breakup time and fluorescein clearance tests were performed. RESULTS: There was a median of 1, 2, and 3 subjective symptoms in PC1, PC2, and PC3 groups respectively (p < 0.001). Patients with larger papillae on their upper tarsus had more subjective symptoms such as burning sensation, discharge, limbal injection, foreign body sensation and dryness sensation (p = 0.018, 0.001, 0.004, 0.005, and 0.036 respectively). They also had shorter tear film breakup time (p = 0.05), delayed tear clearance (p = 0.002) and more corneal neovascularization (p < 0.001). Patients having delayed tear clearance test tended to have more subjective symptoms (p = 0.004) and larger papillae on upper tarsus (p = 0.002). However, neither the way the patients cleaned their contact lenses nor their enzyme cleaning frequency associated with the tear fluorescein clearance (p = 0.528 and 0.394, respectively). Meibomian gland dysfunction and corneal neovascularization did not correlate with the delayed tear clearance either (p = 0.111 and 0.717, respectively). CONCLUSIONS: Tear clearance in contact lens associated papillary conjunctivitis patients was delayed. We proposed that delayed tear clearance might increase the protein and inflammatory mediator concentrations in the tear film and contribute to the pathogenesis or aggravate the severity of contact lens associated papillary conjunctivitis.

Adult↗
PubMed2003

The effect of topically applied secretory leukocyte protease inhibitor on the eosinophil response in the late phase of allergic conjunctivitis.

PURPOSE: This study examined the effects of secretory leukocyte protease inhibitor (SLPI), a protease inhibitor in tears, in allergic conjunctivitis. METHODS: Conjunctiva of male Hartley guinea pigs sensitized with ovalbumin were treated with SLPI or the vehicle 10 min before antigen challenge or simultaneously. The animals were sacrificed after antigen challenges of 0-24 h duration, and the inhibition of eosinophil conjunctival migration and degranulation by SLPI was analyzed histochemically. The effects of SLPI on mast cell chymase and tryptase were also examined. RESULTS: Treatment of sensitized guinea pigs with SLPI suppressed the conjunctival recruitment and degranulation of eosinophils after antigen challenge for 6 h, inhibiting the development of allergic conjunctivitis. The effects of SLPI were observed at concentrations > or =0.1 microM, with a peak at 5 microM. SLPI inhibited chymase in a dose-dependent manner, but had no effect on tryptase. CONCLUSION: The topical SLPI application may be therapeutic in allergic conjunctivitis.

Administration, Topical↗
PubMed2002

Discoid lupus erythematosus and cicatrizing conjunctivitis: clinicopathologic study of two cases.

BACKGROUND: Discoid lupus erythematosus (DLE) demonstrates both cutaneous and mucosal manifestations. Mucosal involvement is typically limited to the oral and anogenital mucosa. Conjunctival involvement in DLE is rare, especially in the absence of accompanying cutaneous disease. OBJECTIVE: We describe the clinical and immunopathologic features of two cases of cicatrizing conjunctivitis due to DLE. METHODS: In each patient, the clinical, immunopathologic, and serologic features were reviewed and the results recorded. RESULTS: Both patients presented with cicatrizing conjunctivitis suggestive of mucous membrane pemphigoid. Patient 1 had no history of typical DLE skin lesions. Patient 2 had a history of cutaneous and oral DLE prior to presentation. Histologic, electron microscopic, and direct immunofluorescence examination confirmed the diagnosis DLE in both patients. CONCLUSION: In patients presenting with cicatrizing conjunctivitis, DLE should be considered in the differential diagnosis. Performing appropriate investigations to distinguish conjunctival DLE from other autoimmune diseases with conjunctival involvement such as mucous membrane pemphigoid is critical in selecting an appropriate treatment regimen, in offering an accurate prognosis, and in monitoring for signs and symptoms of disease progression.

Adult↗
PubMed2003

Systemic and ocular antibody responses to inactivated acute hemorrhagic conjunctivitis (AHC) virus; enterovirus 70 (EV70).

PURPOSE: Evaluate the immune response in rabbits injected with EV70, the agent of acute hemorrhagic conjunctivitis (AHC) and AHC associated neuropathy. METHODS: Rabbits were injected intramuscularly with uv-light inactivated EV70 isolate J670/71. Neutralizing activity against EV70 was quantified in serum and tear samples and the immunoglobulin (Ig) classes of the neutralizing activity in serum identified by sucrose gradient ultra-centrifugation. Adjuvant muramyl dipeptide (MDP) was applied topically to assess the role of ocular inflammation on levels of neutralizing antibody, proteins and Ig in tears. The protective effects of human and rabbit sera and interferon-alpha (IFN-alpha) against EV70 were compared in human conjunctival and lens cells. RESULTS: Sera collected at 6 and 13 d contained 19S IgM anti-EV70 neutralizing antibody, while serum collected 21 d post injection contained 19S IgM and 7S IgG anti-EV70 neutralizing antibody. Low titers of anti-EV70 activity (< or =30 U/ml) were detected in tears of seropositive rabbits. MDP induction of conjunctivitis in seropositive rabbits increased tear IgG concentration (3-fold) and anti-EV70 neutralizing antibody titers (> or =10-fold). The protective effect of the rabbit and human sera against EV70 infection in conjunctival, but not lens epithelial cells, was enhanced by the addition of IFN-alpha. CONCLUSIONS: Immunization with uv-light inactivated EV70 elicits a classical humoral immune response in rabbits. The protective activity of serum in EV70-infected human conjunctival cells, but not lens cells, was increased by IFN-alpha. Adjuvant MDP-induced conjunctivitis, increased blood-conjunctival barrier (BCB) permeability and anti-EV70 neutralizing activity in tear of seropositive rabbits. The results suggest immunization with inactivated EV70 could provide systemic as well as ocular protection during natural EV70 infection.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1988

Prevention of neonatal conjunctivitis in Zaire.

With the emergence of chlamydia as a major cause of neonatal conjunctivitis, silver nitrate is no longer the prophylactic agent of choice in many parts of the world. We studied 450 consecutive newborns in north-eastern Zaire in an effort to determine which of two agents provided the most effective prophylaxis. None of 236 newborns treated at birth with 1% silver nitrate and none of 123 treated with 1% tetracycline was found to develop conjunctivitis. Three of 91 "forgotten" babies developed gonococcal conjunctivitis. Nurses, thinking tetracycline was "messy", tended to "forget" to treat babies for whom tetracycline was prescribed. The use of silver nitrate still provides adequate prophylaxis in Zaire. Potential changes in the prophylactic regimen would need to take the perceptions of health care workers into account.

Conjunctivitis, Bacterial↗
PubMed1997

Efficacy of oxymetazoline eye drops in non-infectious conjunctivitis, the most common cause of acute red eyes.

Oxymetazoline (OMZ) is an alpha-adrenergic agonist which causes potent vasoconstriction in various tissues. Thus, its effects on red eye conjunctivitis induced by histamine and arachidonic acid were tested in rabbit eyes. It was found that a brief conjunctivitis induced by 0.01% of histamine can be eliminated effectively by 0.001, 0.004, and 0.016% of OMZ. The long lasting conjunctivitis induced by 0.3% arachidonic acid can also be markedly reduced by 0.004, 0.008, and 0.016% of OMZ. These results indicate that OMZ is a potent, long acting decongestant for conjunctival red eye syndrome.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Primary meningococcal conjunctivitis: report of 21 patients and review.

Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. Twenty-one cases of primary meningococcal conjunctivitis (PMC) are reported herein and 63 cases published in the literature since 1899 are reviewed. In the 84 cases of PMC available for analysis, the male-to-female ratio was 1.76:1; nine of the patients were neonates, 55 were children, and 20 were adults. Conjunctivitis was unilateral in 66.3% of the patients. Gram stain of conjunctival exudate disclosed gram-negative diplococci in all cases in which it was done. Culture of the conjunctival exudate yielded N. meningitidis in all cases, and 44% of the isolated meningococci belonged to serogroup B. Ocular complications, which occurred in 15.5% of the patients, most frequently were corneal ulcers. Systemic meningococcal disease developed in 17.8% of the patients; the overall mortality was 13.3% for patients with PMC complicated by systemic disease. Development of systemic disease was significantly more frequent in patients receiving only topical therapy than in those treated with systemic therapy (31.71% vs. 2.38%; P = .001). Gram-negative diplococci observed in conjunctival exudate are an indication for systemic antibiotic therapy because of the risk of systemic complications associated with the use of topical therapy alone. When properly treated, patients with PMC have a favorable prognosis.

Child, Preschool↗
PubMed1987

Comparative studies on aetiology and epidemiology of viral conjunctivitis in three countries of East Asia--Japan, Taiwan and South Korea.

A total number of 1105 cases with viral conjunctivitis, mainly epidemic kerato-conjunctivitis (EKC) consisting of 354 cases from Sapporo, Japan, of 628 from Kaohsiung, Taiwan and of 123 from Busan, Korea, encountered during the periods, 1980-81 and/or 1983, were studied aetiologically and epidemiologically. Patients were aged from 27 days to 88 years with a peak in the 20-29 year age group. Aetiological diagnoses were established in 610 cases (55%), consisting of 536 cases (49%) caused by adenoviruses and of 74 (7%) by EV 70. The most frequently detected agent was Ad 8 (57%), followed by EV 70 (12%), Ad 3 (9%) and Ad 19 (7%). The aetiological profiles of viral conjunctivitis were generally similar in three cities of East Asia. EKC (70%) was mainly caused by Ad 8, Ad 19 and Ad 37, but AHC (13%) by EV 70 and PCF (5%) by Ad 3 and Ad 11. Ad 19 and Ad 37 isolates in three cities were compared with the cleavage patterns with restriction endonucleases, BamHl, Smal, Sall and Hindlll. All of the Ad 19 isolates tested were identical to Ad 19a reported by Wadell et al, and all but three isolates of Ad 37 were identical to the Ad 37 prototype prevalent in Europe and the US. The three isolates of Ad 37, different from the prototype in cleavage pattern with Hindlll, designated as Ad 37A, were detected in Sapporo and Kaohsiung in 1980. From the cleavage patterns with four restriction endonucleases, Hindlll, BamHl, Sa1l and Sstl, the Ad 8 isolates in 1983 were divided into three subtypes, which were associated with the cities isolated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoviridae↗
PubMed1979

Early-appearing antiviral activity in human tears during a case of picornavirus epidemic conjunctivitis.

The clinical, virological, and immunological courses of a laboratory-acquired hemorrhagic conjunctivitis were followed. Coxsackievirus type A24 (CA24) was isolated from tears for only two days but from sputum and fecal samples for 20 days. Maximal levels of virus were detected in the right eye (10(5.1) 50% tissue culture infective doses/ml) 5-7 hr before conjunctivitis in the right eye, and in feces (10(2.8) 50% tissue culture infective doses/g) and sputum (10(2.5) 50% tissue culture infective doses/ml) five and eight days after onset of conjunctivitis, respectively. Specific neutralizing activity against CA24 was detected in tear samples 48-56 hr after exposure, and elimination of virus was associated with the rise in the neutralizing activity in tears. This activity was detected earlier than previously reported antibody responses of the eye. The absence of interferon and the association of this early neutralizing activity in tears with early elimination of virus from the eye suggest that neutralizing activity may play a major role in the clinical and pathological manifestations of this infection.

Antibodies, Viral↗
PubMed1991

Detection by brush cytology of mast cells and eosinophils in allergic and vernal conjunctivitis.

The presence of eosinophils in the conjunctival epithelium is indicative of allergies, and detection is currently performed by cotton swab scrapings. Although mast cells are thought to be chemotactic for eosinophils and thus presage their accumulation, the former's use as early indicators of allergy has heretofore been hindered by poor detection methods. The recent development of a special brush now makes it possible to collect many cells with less disturbance of the conjunctival epithelium. In the present study, we have used this brush for conjunctival scraping in 18 patients with vernal and allergic conjunctivitis, and 10 patients serving as controls. The superior and inferior tarsal conjunctiva in both eyes were examined, and the specimens were stained using Hansel's method. Mast cells were observed in at least one of the tarsal conjunctivae in all cases of vernal and allergic conjunctivitis, whereas eosinophils were so observed in only eight cases (44.4%). Neither mast cells nor eosinophils were present in the conjunctivae of the normal group. Although treatment by mast cell stabilizers produced clinical remissions, they induced disappearance of mast cells in only 10 cases (55.6%), whereas in six cases (33.3%) the mast cells increased, and in two cases they were unchanged (11.1%). Six cases (33.3%) each showed disappearance of, increase in, and no change in eosinophils, reflecting even less of a response of these allergic cells to the treatment. The presence of mast cells and eosinophils, as determined by our cytologic method, was found to be correlated with the early detection, but not the clinical severity, of allergic conjunctivitis.

Adolescent↗
PubMed2000

The role of nitric oxide in experimental allergic conjunctivitis.

PURPOSE: To evaluate the role of nitric oxide (NO) in the pathogenesis of allergic conjunctivitis and the effect of NO-synthase (NOS) inhibitors. METHODS: The experimental allergic conjunctivitis was provoked in rabbits and healthy human volunteers by mast cell activators (codeine phosphate, 2.5 mg/mL; compound 48/80, 50 mg/mL; and lipopolysaccharide, 10 ng/eye). NOS inhibitors (aminoguanidine [AG], 1.5%, or N(G)-nitro-L-arginine methyl ester [L-NAME], 200 microg/eye) were applied as a pretreatment. In a rabbit model, concentrations of nitrite plus nitrate in the tear were measured colorimetrically using the Griess reaction after 0.5, 1.5, 3, 6, and 9 h. Immunohistochemical study for NOS was performed. The clinical scoring was performed in human volunteers. The vascular permeability was determined by measuring the albumin content in the tear of the challenged human eyes after 1 h. RESULTS: After the instillation of mast cell activator, the NO level and clinical symptoms were markedly increased within 1.5 h. The NOS inhibitors suppressed the NO level. Vascular permeability was also increased in the activator-treated group. The NO-synthase immunoreactivity has been detected in the conjunctival subepithelial area and stroma for brain and endothelial isoform. L-NAME significantly reduces the immunoreactivity for NOS. CONCLUSION: These results suggest that the expression of NOS mainly contributes to the allergic symptoms. Therefore, NO is an important factor in the induction and progress of the allergic reaction to ocular surface. The NOS inhibitors may have a beneficial effect for allergic conjunctivitis.

Adult↗
PubMed2003

Effects of lacrimal occlusion with collagen and silicone plugs on patients with conjunctivitis associated with dry eye.

PURPOSE: To determine whether canalicular occlusion with collagen and silicone plugs reduces the severity of symptoms in patients with conjunctivitis secondary to dry eye. METHODS: This was a prospective, randomized, double-masked study conducted at a single center in Mexico, in which 61 patients with dry eye/conjunctivitis were assigned to progressive lacrimal occlusion with collagen and silicone plugs or a sham procedural group. Outcome variables included total and individual dry eye and conjunctivitis symptom scores, moisturizing agent usage, best-corrected visual acuity, ocular comfort level, visual performance, corneal/conjunctival fluorescein staining, and incidence of adverse events. RESULTS: Total dry eye and conjunctival symptom scores were reduced by 43.7 and 33.7%, respectively 2 weeks after occlusion of all four lacrimal canaliculi with collagen plugs, increasing to 77.4 and 72.1% 2 weeks later following superior canalicular occlusion of both eyes with silicone plugs and inferior placement of collagen plugs. At the 8-week visit (4 weeks after silicone plug implantation of the inferior canaliculi of both eyes), the reduction in total dry eye and conjunctival symptom scores further increased to 94.2 and 93.0%, respectively, accompanied by a marked decline in each of the seven individual symptom scores (dryness, watery eyes, itching, burning, foreign body, fluctuating vision, and light sensitivity). In concert with these changes, moisturizing agent usage and corneal/conjunctival fluorescein staining decreased in a progressive fashion over the 8-week study period, and best-corrected visual acuity, ocular comfort, and visual performance improved in the absence of any treatment-related adverse events except for one case of epiphora. The response of patients to lacrimal occlusion can be sharply contrasted with the sham procedure group, which remained relatively unchanged from baseline at each of the study visits. CONCLUSIONS: Progressive lacrimal occlusion with collagen and silicone plugs was of clinical benefit to patients with dry eye and conjunctivitis.

Adult↗
PubMed2003

Efficacy and safety of topical azelastine compared with topical mitomycin C in patients with allergic conjunctivitis.

PURPOSE: To compare the efficacy and safety of topical azelastine with topical mitomycin C (MMC) in patients with allergic conjunctivitis. METHODS: Sixty-three patients (29 male, 29 female; 34 in the age range of 6 to 65 years) with allergic conjunctivitis were enrolled in this study. The patients were randomly assigned to receive topical azelastine 0.02% (n = 31) or topical MMC (0.2 mg/10 mL) (n = 31) four times daily for 3 months. Follow-up examinations were done at 2 weeks to examine side effects of the medications and again at 4 weeks to assess the outcome of treatment. The eyes were examined for relief of symptoms, cure of signs, and the appearance of side effects with use of these drugs. RESULTS: The mean age of the patients in this study was 34.8 +/- 17.3 years. The age of patients in the MMC group was significantly higher than patients in the azelastine group (mean +/- SD, 25.2 +/- 13.5 years). More patients in the MMC group had relief of symptoms like redness [25 (80.7%) in the MMC group versus 19 (55.9%) in the azelastine group; p= 0.033], photophobia [11 (35.5%) in the MMC group versus six (17.7%) in the azelastine group; not significant], discharge [17 (54.8%) in the MMC group versus 11 (32.3%) in the azelastine group; not significant], and foreign body sensation [21 (67.7%) in the MMC group versus 16 (47.1%) in the azelastine group; not significant], while more patients in the azelastine group had relief of lacrimation [14 (41.2%) in the azelastine group versus 10 (32.3%) in the MMC group; not significant] and pain [12 (35.3%) in the azelastine group versus eight (25.8%) in the MMC group; not significant]. The MMC group also showed a greater decrease in follicles [31 (100.0%) in the MMC group versus six (17.7%) in the azelastine group; p= 0.0001] and papillae [29 (93.6%) in the MMC group versus four (11.8%) in the azelastine group; p= 0.0001]. Both drugs were found to be equally effective in relieving itching [18 (58.1%) in the MMC group versus 18 (52.9%) in the azelastine group; not significant]. In the MMC group, 27 (87.1%) patients had conjunctival hyperemia, 28 (90.3%) patients had episcleritis, and 29 (93.6%) patients had irritation. The use of topical azelastine did not cause any adverse event. CONCLUSIONS: Though this was a short-term study, we found topical MMC to be more effective than topical azelastine in the treatment of allergic conjunctivitis both in terms of relief of symptoms and resolution of signs. The use of topical MMC in low doses does not cause any significant adverse effect.

Administration, Topical↗