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The treatment of migraine with variable frequency photo-stimulation.

Variable Frequency Photo-stimulation (VFP) goggles are a form of portable stroboscope, using red Light Emitting Diodes to alternately illuminate the right and left eyes, with the eyelids closed, at a rate of 0.5 to 50 Hz. VFP goggles were used in the treatment of 7 patients with migraine headache. Of 50 migraine headaches recorded, 49 were rated by the patient as being helped and 36 as being stopped by using the VFP goggles. Treatment reduced the median duration of headache in all patients. The interval between migraine headaches appeared to be increased in the two cases with a follow up of more than 18 months. We conclude in this preliminary study that VFP appears to be effective in the treatment of migraine.

Adult↗

Suppressive efficacy by a commercially available blue lens on PPR in 610 photosensitive epilepsy patients.

PURPOSE: Photosensitivity can represent a serious problem in epilepsy patients, also because pharmacologic treatment is often ineffective. Nonpharmacologic treatment using blue sunglasses is effective and safe in controlling photosensitivity, but large series of patients have never been studied. METHODS: This multicenter study was conducted in 12 epilepsy centers in northern, central, southern, and insular Italy. A commercially available lens, named Z1, obtained in a previous trial, was used to test consecutively enrolled pediatric and adult epilepsy patients with photosensitivity. Only type 4 photosensitivity (photoparoxysmal response, PPR) was considered in the study. A standardized method was used for photostimulation. RESULTS: Six hundred ten epilepsy patients were tested. Four hundred (66%) were female patients; 396 (65%) were younger than 14 years. Three hundred eighty-one (62%) subjects were pharmacologically treated at the time of investigation. Z1 lenses made PPR disappear in 463 (75.9%) patients, and PPR was considerably reduced in an additional 109 (17.9%) of them. PPR remained unchanged only in the remaining 38 (6.2%) patients. The response of PPR to Z1 lenses was not significantly influenced by the patients' age, sex, or type of epilepsy. No difference was found between pharmacologically treated and untreated patients. CONCLUSIONS: The Z1 lens is highly effective in controlling PPR in a very large number of photosensitive epilepsy patients irrespective of their epilepsy or antiepileptic drug treatment. The lens might become a valid resource in the daily activity of any clinician who cares for patients with epilepsy.

Adolescent↗

Optical hazard evaluation of dental curing lights.

The potential ocular hazards associated with the use of dental curing lights were evaluated. Recommendations are provided for precluding exposure of personnel to hazardous levels of optical radiation. Users should not stare directly into the dental curing lights at distances shorter than 25 cm (which would not be a likely event). Eye protectors which filter wavelengths below 500 nm may be desired by individual users to reduce discomfort or if surface lamination is applied.

Dental Restoration, Permanent↗

Gender differences in characteristics, infection control practices, knowledge and attitudes related to HIV among Ontario dentists.

We surveyed 5,997 dentists in Ontario to investigate gender differences in the characteristics, infection control practices, knowledge and attitudes regarding the treatment of HIV-infected patients. The response rate was 70.3%. Reports indicated that female dentists are younger and more likely to work in larger urban centres (P < 0.00001), and in general practice (P < 0.0001) than their male counterparts. Multiple logistic regression analyses indicated that many significant gender differences in the univariate analyses could be explained by the confounding influence of age, practice location, and specialty; however, some differences remain significant: Women were more likely than men to report attending continuing education dealing with HIV/AIDS in the past two years (P < 0.001), and to use masks and eye protection (P < 0.00001). Men reported more economic concerns than women: they were more concerned about the financial burden of infection control costs (P < 0.00001), and losing patients from their practice if it is known that they treat patients with HIV (P < 0.05). However, there were no significant differences in willingness to provide treatment for patients with HIV. We conclude that there is little evidence to show that access to oral care for patients with HIV is affected by gender differences.

Acquired Immunodeficiency Syndrome↗

Raccoon-like periorbital leukoderma from contact with swim goggles.

A 12-year-old girl developed a periorbital leukoderma from contact with swim goggles. She had worn the same goggles the preceding year and re-used them after the leukoderma had cleared without any ill effects. The hypopigmentation was believed to be caused by the leakage of breakdown products in the neoprene rubber or glue. These breakdown products may have caused a toxic rather than an allergic reaction on skin contact, inhibiting melanin production possibly by competitive inhibition of tyrosine oxidation. These chemical compounds probably leaked from the goggles and were eventually exhausted. This possibility may explain why the leukoderma did not recur after re-use of the goggles.

Child↗

Dermatitis from phenyl salicylate in safety spectacle frames.

We report 3 cases of allergic contact dermatitis behind the ears from wearing the same brand of industrial safety spectacles. In each case, a positive patch test was obtained with scrapings of the plastic frame. In 2 cases further patch tests with constituents of the plastic were carried out; positive patch tests were obtained with phenyl salicylate. Phenyl salicylate is used as an ultraviolet inhibitor in some cellulose acetate butyrate and cellulose acetate propionate formulae. It has previously been reported as a contact sensitizer from its use as a sun screen in a lip salve. Positive patch test reactions were also obtained variously in these patients with balsam of Peru, resorcinol monobenzoate, and epoxy resin.

Adult↗

Ultraviolet radiation-blocking characteristics of contact lenses: relevance to eye protection for psoralen-sensitised patients.

Nine brands of contact lens marketed as "UV protective" were tested for ultraviolet (UV) transmission in order to assess potential suitability for psoralen-sensitised patients. UV-transmission characteristics of hydrated lenses was tested with a Bentham monochromator spectro-radiometer system. All lenses showed minimal transmission loss in the visible band. The performance of the nine lenses was uniform for ultraviolet B radiation with negligible transmission, but showed variation in transmission for ultraviolet A radiation. None of the lenses complied with UV-transmission criteria used previously to assess UV-blocking spectacles. Only two lenses had UV-blocking characteristics which came close to the arbitrary criteria used. The performance of ordinary soft and hard lenses was very similar, with negligible blocking of UV radiation. None of the nine contact lenses marketed as "UV protective" excluded sufficient UVA to comply with criteria in current use to assess UV protection in spectacles for psoralen-sensitised patients. However, the improved UV-blocking characteristics of contact lenses identified in this paper compared to previous studies suggests that such a contact lens will soon become available. Meanwhile, contact lens-wearing systemically sensitised PUVA patients should continue to wear approved spectacles for eye protection whilst photosensitised with psoralen.

Contact Lenses↗

Cross-infection compliance of UK dental staff and students.

OBJECTIVES: The objectives of the study were to determine the compliance of a group of dental health care workers and students in aspects of cross-infection control. DESIGN: The dentists and dental students working in a dental clinic were observed by a 'hidden' ceiling-mounted video camera. Procedures were recorded onto videotape and the actions of the observed clinicians and students assessed by two suitably qualified assessors. SETTING: An emergency Oral Medicine clinic in a dental hospital. SUBJECTS: Seventy nine dentists and 35 dental undergraduates. METHODS: The action of staff and students were recorded on videotape and assessed retrospectively. MAIN OUTCOME MEASURES: Degree of compliance with recognised infection control policies. RESULTS: Compliance with recommended guidelines for control of cross-infection was poor. In only 56% of health care worker-patient contacts were protective gloves changed between patients. Facemasks and protective eyewear were only worn in 38% and 29% of such contacts respectively. CONCLUSIONS: Compliance with cross-infection control measures are poor in dentistry--even when clinicians are provided with appropriate facilities.

Attitude of Health Personnel↗

The biological effects of UV-B on the eye.

The adverse effects of ultraviolet-B (UV-B) radiation on the eye have been suspected but only recently have they been quantified by epidemiologic studies in humans. These studies became possible as methods to qualify individual ocular UV-B exposure were developed. A consistent dose-dependent association between ocular UV-B exposure and two common types of cataract (cortical and posterior subcapsular) has been shown. Although suggested by experimental studies, at present, evidence does not exist to link UV-B exposure to senile macular degeneration. Ocular exposure to UV-B is also associated with several corneal changes, pterygium, climatic droplet keratopathy, and acute photokeratitis (snow blindness). Significant reduction in ocular UV-B exposure results from the use of eyeglasses and hats.

Cataract↗

Barrier techniques and hepatitis B vaccine policies in dental components of local health agencies.

National health organizations have issued guidelines for barrier control techniques against infectious diseases and for inoculation against hepatitis B. This study surveys the policies of local health agencies regarding the safeguards used in protecting their employees. Local health agencies (N = 201) operating independently of state health departments were mailed questionnaires seeking information regarding glove, mask, and eyewear policies, as well as hepatitis B vaccine policies for new and current employees. Of the 156 programs returning the survey, 127 (76.6%) reported having a clinical component. Many agencies did not require infection control policies to be implemented for every patient. Agencies that had dental directors who have held their positions for fewer than four years were more likely to have requirements for gloves and masks than agencies run by directors with longer tenure. Those agencies that provided dental treatment to inmates at correctional institutions were also more likely to require infection control policies. The data indicate policy inconsistencies among local dental health programs nationwide. Of considerable concern is the fact that infection control was not identified as a priority for the near future. Many local health agencies would benefit from further education in infection control.

Communicable Disease Control↗

Contact lenses and mechanical trauma to the eye. An experimental study.

Eyes of anaesthetized rabbits, fitted with contact lenses, were exposed to showers of burning grit particles. Hard contact lenses provided efficient protection for the covered part of the cornea. Soft lenses also had a certain protective effect since the majority of the particles rebounded and the others caused only superficial epithelial damage to the cornea. The soft lenses were themselves heavily damaged. Exposure to attack by large particles of metal was also tested. The hard lenses, which splintered at a lower energy than that required for penetration of the cornea, could increase the risk of injury by penetration of splinters of plastic. Soft lenses with high liquid content constituted neither a protection nor a risk. Soft lenses with low water content were, however, significantly different from the other types since a considerably higher momentum of the particles was required for penetration of the cornea when covered by such lenses.

Accidents, Occupational↗

The role of occupational health physician in protection of the eyes and vision.

Eye protection and preventive health care of eyes need activity of occupational health care. Most success in the prevention of occupational eye injuries can be done in changing wrong attitudes in the work place. With bad vision the employee does not succeed in his work. Refraction should be corrected to get good visual acuity. In prevention of occupational eye injuries it is valuable to look all over the work places in order to get perfect eye protection. The use of safety glasses or other equipment should be encouraged and controlled. Information on the right use of contact lenses and good first-aid may complete your success in protection of eyes and vision.

Attitude↗