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PubMed2003

[Epidemiology of allergic eye diseases].

Epidemiology of allergic eye diseases has not been sufficiently studied so far. The first statistical studies regarded the coexistence of allergic conjunctivitis together with allergic rhinitis, as rhinoconjunctivitis. Only in the last 10 years eye allergy has been regarded as a separate epidemiological and clinical problem. According to Bonini, seasonal allergic conjunctivitis (SAC) accompanies pollinosis in 95.2%. Buckley's studies revealed symptoms of SAC in 21% of British population and Berdy reported a similar result in 20% of Americans. Weeke estimates that depending on geographical region and age of examined patients, allergic eye diseases occur in 5 to 22% of the population. Among them SAC and perennial allertgic conjunctivitis (PAC) account for up to 50%. A recent Italian study demonstrated an increase of the incidence of allergic eye diseases, which were found in 38% of the studied population, most frequently in young males. Eye allergy presented most frequently as rhinoconjunctivitis (SAC and PAC) (63.7%), and then as atopic keratoconjunctivitis (AKC) (21%) and vernal keratoconjunctivitis (VKC) (15.5%). It seems that the incidence of allergic eye diseases demonstrates a rising tendency, similarly as it has been found in recent years in the case of bronchial asthma, rhinitis or atopic dermatitis.

Conjunctivitis, Allergic↗
PubMed2001

[Eye diseases in sleep apnea syndrome].

Sleep apnea syndrome is characterized by recurrent complete or partial upper airway obstructions during sleep and recognized as an important risk factor for cardiovascular and cerebrovascular diseases. Several eye diseases have been associated with sleep apnea syndrome. Due to floppy eyelids often a chronic conjunctivitis occurs. A leaking mask used for apnea treatment may also induce a conjunctivitis. The lids may show an upper lid ptosis, lower lid ectropium, blepharochalasis, or trichiasis. Corneal findings include infectious keratitis, dry eye, recurrent erosion, keratoconus, and progressive endotheliopathy. Several optic neuropathies also seem to be associated with sleep apnea syndrome.

Blepharoptosis↗
PubMed1994

Childhood eye diseases in Ibadan.

Eye diseases in 1028 children below 15 years of age, seen at the Eye clinic of the University College Hospital, Ibadan, Nigeria were studied. Refractive error, vernal conjunctivitis, measles keratitis associated with malnutrition and those referrable to injuries were leading causes of eye problems amongst children. Diseases of ocular adnexa (excluding orbital cellulitis) squints, glaucoma, uveitis and trachoma were rare.

Adolescent↗
PubMed1992

Diagnostic tests for dry eye disease in normals and dry eye patients with and without Sjögren's syndrome.

In order to compare the diagnostic tests for dry eye disease and the results of conjunctival impression cytology, we examined three groups of eyes: 146 eyes of normal controls, 108 eyes of keratoconjunctivitis sicca (KCS) patients without Sjögren's syndrome (SS) and 102 eyes of patients with SS. The clinical tests (break-up time, Schirmer test, Rose Bengal staining) and conjunctival impression cytology specimens from the superior part of the bulbar conjunctiva were evaluated from all the eyes. Our results showed that the patients with KCS without SS have abnormal lacrimal tests (p < 0.001) without changes in impression cytology [nucleo/cytoplasmic ratio (N/C), p > 0.1]. The patients with KCS and SS have also abnormal lacrimal tests (p < 0.01), and their epithelial cells presented squamous metaplasia (N/C, p < 0.001). The goblet cell number remained unchanged in the three groups (p > 0.1).

Adolescent↗
PubMed2000

Self-reported eye disease in elderly South Asian subjects from an inner city cluster in Bradford: a small-scale study to investigate knowledge and awareness of ocular disease.

PURPOSE: To investigate various issues relating to eye diseases in a sample of 200 South Asian residents living in an inner city regional cluster in Bradford. METHODS: Door to door interviews were carried out by one investigator who spoke English, Punjabi and Urdu. Visual acuity and pinhole acuity were measured using a portable LogMAR acuity chart. A structured questionnaire investigated various issues including self-reported eye disease, knowledge of eye disease, the effectiveness of various sources for eye-related information, the importance of early detection of eye diseases and the need for adequate control of systemic diseases linked to eye diseases such as diabetes. RESULTS: Data revealed poor knowledge of self-reported eye diseases and of the importance of early detection and inadequate knowledge of the link between the control of systemic disease such as diabetes and ocular complications. Language barrier problems and poor utilisation of available ocular health care services were also evident. CONCLUSIONS: These data, although not exhaustive, give an insight into various factors that affect the ocular health of the South Asian community in Bradford.

Aged↗
PubMed1998

Botulinum toxin A treatment of overactive corrugator supercilii in thyroid eye disease.

BACKGROUND/AIM: Patients with thyroid eye disease with upper eyelid retraction often develop overaction of the accessory muscles of eyelid closure, the glabellar muscles corrugator supercilii and procerus. The resultant glabellar furrowing (frown lines) contributes to the typical thyroid facies. The aim of this study was to evaluate the use of botulinum toxin A reversible chemodenervation of the glabellar muscles as adjunctive treatment in the rehabilitation of patients with thyroid eye disease. METHODS: 14 patients (13 females) ages 39-76 years (mean 52) with inactive thyroid eye disease and associated medial eyebrow ptosis and prominent glabellar frown lines were recruited. All patients had a history of upper eyelid retraction. Each patient was treated with a single botulinum toxin injection (Dysport 0.2 ml, 40 units) into each corrugator supercilii and sometimes procerus muscles as an outpatient procedure. The effectiveness and acceptability of the treatment was assessed clinically and from a patient questionnaire. RESULTS: The injections were tolerated by 13/14 (93%) patients. There was resultant flattening of the glabellar region and improvement of medial eyebrow contour in all patients, with onset of paralysis within 1 week. All patients reported a subjective improvement in appearance. Side effects included one patient (7%) with reversible partial ptosis. The beneficial effect lasted 4-6 months, with a gradual return of function. Repeat treatment was indicated where there was persistent upper eyelid retraction and protractor overaction. CONCLUSION: Botulinum toxin A chemodenervation of the glabellar muscles in these patients was effective and acceptable. Chemodenervation should be considered in the rehabilitation of patients with thyroid eye disease where there is upper eyelid retraction and overacting protractors resulting in a thyroid frown. Once the eyelid retraction has been successfully treated by surgery, the need for further glabella muscle chemodenervation is considerably reduced.

Adult↗
PubMed1982

Eye disease in the Navajo indians.

The ocular disease distribution and causes of blindness in the Navajo Indians are discussed. Trauma, usually associated with alcohol ingestion, is the most common cause of monocular blindness. Corneal scars, glaucoma, and retinal detachment are the other leading causes of blindness. Stage IV trachoma is frequently seen in the elderly, but active trachoma is present in only about 1% of Navajo children, a dramatic decline from the past. Pterygium, phlyctenular disease, limbal vernal catarrh, trachoma, pseudoexfoliation of the lens, phakomorphic angle closure glaucoma, iridocyclitis, retinitis pigmentosa, and high corneal astigmatism occur more commonly than in the general US population. Mature cataracts and retinoblastoma may be more prevalent. Acute spontaneous angle-closure glaucoma, unrelated to cataracts, has not been seen. Large pterygia, the most common external problem frequently cause corneal distortion and visual disturbances.

Adult↗
PubMed1988

Major histocompatibility complex (MHC) factors predisposing to and protecting against Graves' eye disease.

We investigated the influence of gene mapping within the major histocompatibility complex on the susceptibility to Graves' eye disease. We studied 133 randomly selected patients with Graves' disease, many of whom had eye disease. HLA B8 and DR3 carried the greatest risk for disease but the difference between the two patient groups was not statistically significant. An earlier finding that Hungarian patients with a subset of B8, (B8 + DR7 +) had a greatly enhanced risk for eye disease was confirmed in Newfoundland patients. HLA B8 and DR7 are probably carried on different homologous chromosomes and their interaction enhances eye disease. HLA-DR4 was negatively correlated with eye disease. In particular, a subset of DR4 (B35 + DR4 +) appears to protect against eye disease. We have also derived the haplotypes of 22 probands, half of whom had eye disease. The haplotype data emphasized the high frequency of HLA A1 B8 DR3 C4A*QO and C4B*1 in both patient groups, 15% of the haplotypes in the group with eye disease and 25% in that without eye disease. Forty-one percent of haplotypes in the eye disease group and 32% in the no eye disease group were either C4A*QO or C4B*QO. In one proband with eye disease B8 and DR7 were carried on separate chromosomes. The phenotype DR4, C4A*3 C4B*1 was found in 3/20 haplotypes of patients without eye disease but in 0/20 of patients with eye disease. This finding is in keeping with the increased frequency of the DR4 C4A*3 C4B*1 in the patient group with no eye disease when 94 patients were phenotyped.(ABSTRACT TRUNCATED AT 250 WORDS)

Disease Susceptibility↗
PubMed1983

Eye diseases and services in Tanzania.

Since the Arusha Declaration of 1977, Tanzania has stressed the provision of essential services to rural areas as part of Rural Development. This was to provide essential services such as schools, hospitals and clean water, all of which were disproportionately available in the urban areas in spite of the fact that about 90% of the total population lived in rural areas. Thus the aim of the Ministry of Health was: (a) to strengthen primary health care; and (b) to train enough personnel to deliver the necessary services. In order to do this the Ministry had to reorganise its infrastructure and training programmes. This was achieved by building more primary health centres, rural health centres and by strengthening the District, Regional and Consultant hospitals. Tanzania, like any developing country, suffers from the triad of poverty, ignorance, and disease. To combat eye diseases we need more than just health workers. Planners, social workers, school teachers, agriculturists, politicians and the people themselves especially those living in rural areas have to be alerted and organised to combat the effects of eye diseases. Only by doing so can the specialist, the assistant medical officer ophthalmology and the ophthalmic nurse, do their jobs. Also needed are good and easy methods of delivery of these services. This means the availability of efficacious and cheap drugs and a good communication network.

Blindness↗
PubMed1985

Evidence for deficiency of high density lipoprotein lecithin: cholesterol acyltransferase activity (alpha-LCAT) in fish eye disease.

In a rare familial condition, fish eye disease, there is a low relative content of cholesteryl esters in the plasma high density lipoproteins (HDL) but a normal content of these lipids in the very low (VLDL) and low (LDL) density lipoproteins. Lecithin: cholesterol acyltransferase (LCAT) is the enzyme which mediates the esterification of free cholesterol in the plasma lipoproteins. In the present investigation, isolated HDL from our two fish eye disease patients were found to be excellent substrates during in vitro incubations with normal LCAT as present in lipoprotein depleted plasma from control subjects. Almost all free cholesterol of these HDL fractions became esterified and concomitantly the abnormally small fish eye disease HDL particles increased to a size in the range of that of normal HDL particles. Lipoprotein depleted plasma from fish eye disease, however, lacked the property of normal plasma to esterify the free cholesterol of HDL isolated from plasma of fish eye disease patients or control subjects. These results have led to the formulation of a new concept implying that two different LCAT activities exist in normal plasma. One of these activities, denoted alpha-LCAT, is specific for HDL (alpha-lipoproteins) and the other, beta-LCAT, is specific for VLDL-LDL (pre beta- and beta-lipoproteins). Fish eye disease according to this notion is classified as an alpha-LCAT deficiency in contrast to the classical LCAT deficiency which probably lacks both alpha- and beta-LCAT activities.

Aged↗
PubMed1983

Methodological problems in eye disease epidemiology.

The recent burst of activity in eye disease epidemiology, occasioned by increases in the number of ophthalmologists with training in epidemiology and of epidemiologists interested in eye diseases, makes this an appropriate time for taking stock of methodological problems in this field. In this review, based largely on the author's personal encounter with five large epidemiologic studies (2, 7, 19, 30, 39) of the four major chronic eye diseases (senile cataract, senile macular degeneration, diabetic retinopathy, and glaucoma), the following methodological areas are discussed: quality assurance; disease definitions and classifications; reproducibility of observations; visual acuity and visual field tests; needed technologic advances; study design of case-control studies and clinical trials; and data analysis (shall we count subjects or eyes?). The chief weakness of blindness registers has been inadequate evaluation of the extent of underregistration and of the variability of underregistration according to socioeconomic and racial subgroups. The Health and Nutrition Examination Survey (HANES), conducted by the United States Public Health Service, is a potentially valuable source of descriptive and analytic epidemiologic information on eye diseases. It is an examination of a large probability sample of the US population and includes various histories, clinical and laboratory examinations, and a nutrition interview. In the early 1970s, HANES included eye examinations, but these were curtailed because of inability to get ophthalmologists as examiners. In future HANES studies, efforts should be made to minimize the involvement of ophthalmologists in the eye examinations and to increase the use of nonophthalmologists (e.g., optometrists, technicians) and instruments (e.g., cameras, densitometers, automated perimeters). The validity and reliability of any new procedures will need to be determined. Studies may need to be limited to certain major eye diseases and conditions. Population glaucoma surveys have tended to omit partially or entirely the time-consuming visual field test. Yet, without this test, the diagnostic examination for glaucoma is incomplete. The automated perimeter, with which visual fields can be more quickly measured, promises to be an important screening tool for glaucoma prevalence and case-finding surveys. It should be field-tested for epidemiologic use. The absence of standardized disease definitions, without which comparisons between studies are uncertain, has been a handicap to epidemiologic research in eye disease. A first constructive step toward the development of disease definitions would be the development of disease classifications.(ABSTRACT TRUNCATED AT 400 WORDS)

Blindness↗