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PubMed1993

Ligneous conjunctivitis. Ten years follow-up.

Ligneous conjunctivitis is a rare chronic conjunctivitis of unknown origin occurring predominantly in young girls. Persistent whitish membranes, 1-2 mm in thickness, are present on the upper and, less frequently, on the lower tarsal conjunctiva. The authors present a 12-year-old girl who is suffering from this disease since the age of four months. The diagnosis was confirmed histologically. Multiple recurrences were observed and were treated either conservatively with hyaluronidase eyedrops or surgically. At the present time, the disease has settled to a tolerable level.

Child↗
PubMedDate not supplied

Mycoplasmal conjunctivitis in wild songbirds: the spread of a new contagious disease in a mobile host population.

A new mycoplasmal conjunctivitis was first reported in wild house finches (Carpodacus mexicanus) in early 1994. The causative agent was identified as Mycoplasma gallisepticum (MG), a nonzoonotic pathogen of poultry that had not been associated with disease in wild songbirds. Since the initial observations of affected house finches in the mid-Atlantic region, the disease has become widespread and has been reported throughout the eastern United States and Canada. By late 1995, mycoplasmal conjunctivitis had spread to an additional species, the American goldfinch (Carduelis tristis). This new disease exemplifies the rapid spread of a pathogen following introduction into a mobile wildlife population and provides lessons that may apply to emerging human diseases.

Animals↗
PubMedDate not supplied

Acute hemorrhagic conjunctivitis due to enterovirus 70 in India.

An outbreak of acute hemorrhagic conjunctivitis occurred in Delhi, India, during August and September 1996. The etiologic agent was confirmed as enterovirus type 70 by a modified centrifugation-enhanced culture method followed by immunofluorescence and neutralization tests. After nearly a decade, this virus is reemerging as a cause of acute hemorrhagic conjunctivitis in India.

Adolescent↗
PubMed1998

An outbreak of non-sexually transmitted gonococcal conjunctivitis in Central Australia and the Kimberley region.

From 13 February to 27 June 1997, 447 cases of gonococcal conjunctivitis were identified by Communicable Disease and Public Health Centres and Community Clinics in the Northern Territory, Western Australia and South Australia. The outbreak involved Aboriginal communities predominantly in Central Australia and the Kimberley region in Western Australia. This was the first outbreak recorded in the Kimberley region. It is not yet known whether the Kimberley cases were part of the larger Central Australian outbreak or whether they represented a separate and unrelated outbreak. Environmental factors associated with this outbreak were similar to those seen in previous outbreaks. Control measures were based on early recognition and treatment of index cases and identifying and treating contacts. Until sexually transmitted Neisseria gonorrhoeae is controlled in communities gonococcal conjunctivitis is likely to appear again. The role of oropharyngeal carriage of N. gonorrhoeae needs to be evaluated further.

Adolescent↗
PubMed2002

Refining the public health response to primary meningococcal conjunctivitis.

Primary meningococcal conjunctivitis (PMC) is accepted as an uncommon condition. This report describes two recent cases of PMC in newborn infants in a hospital nursery. In both cases the organisms identified were non-groupable strains of N. meningiditis, considered to be of low pathogenic potential. Both infants received systemic therapy and recovered without sequelae. The Guidelines for the early clinical and public health management of meningococcal disease in Australia recommend the notification of PMC to public health authorities and chemoprophylaxis of contacts. However, our 2 cases suggest that the guidelines should allow for an assessment of risk in determining the public health response. This assessment should include the severity of the conjunctivitis and the serogroup of the N. meningitidis isolate.

Anti-Bacterial Agents↗
PubMed2005

Engagement of 4-1BB inhibits the development of experimental allergic conjunctivitis in mice.

The 4-1BB receptor acts as a costimulator in CD8(+) T cell activation. Agonistic stimulation through this molecule by treatment with anti-4-1BB Abs has been demonstrated to inhibit various experimentally induced diseases in animals. However, the effect of anti-4-1BB Abs on experimental allergic diseases has not been reported. We investigated the effect of anti-4-1BB Abs on the development and progression of experimental allergic conjunctivitis in mice. To examine the effects of Abs during the induction or effector phase, actively immunized mice or passively immunized mice by splenocyte transfer were treated with agonistic anti-4-1BB Abs, blocking anti-4-1BB ligand Abs, or normal rat IgG. Eosinophil infiltration into the conjunctiva was significantly reduced in wild-type mice by the anti-4-1BB Ab treatment during either induction or effector phase. Th2 cytokine production by splenocytes and total serum IgE were significantly reduced by the anti-4-1BB Ab treatment, while IFN-gamma production was increased. The anti-4-1BB Ab treatment induced a relative increase of CD8-positive cell numbers in the spleens. Moreover, inhibition of eosinophil infiltration by the treatment with anti-4-1BB Abs was also noted in actively immunized IFN-gamma knockout mice. Taken altogether, in vivo treatment with agonistic anti-4-1BB Abs in either induction or effector phase inhibits the development of experimental allergic conjunctivitis, and this inhibition is likely to be mediated by suppression of Th2 immune responses rather than up-regulation of IFN-gamma.

Animals↗
PubMed1999

Seasonal allergic conjunctivitis: overview and treatment update.

Seasonal allergic conjunctivitis is rarely associated with permanent vision impairment; however, it is a relatively common condition that may compromise the quality of life. It may, in extreme cases, impair daily activities, including work. Numerous treatment options have become available for the relief of acute symptoms. Avoidance should always be the first line in therapy but, in most cases, is not practical, especially with pollen allergies. The use of saline eyedrops is simple and nontoxic, and it is effective in up to 30% to 35% of cases. It can and should be added to all other remedies to reduce adverse effects and cost by decreasing the need for other therapeutic options. Antihistamines and decongestants are useful treatment choices for the majority of cases. Ketorolac tromethamine may be helpful in relieving pruritus, but it offers little advantage over topical antihistamines. Corticosteroids may be used for severe cases for a limited time. If topical corticosteroids are being considered, an ophthalmologist should be consulted. Cromolyn sodium and lodoxamide ophthalmic solution may be helpful in the prophylaxis of symptoms during the allergy season, but these agents require frequent dosing. Olopatadine hydrochloride is a mast cell stabilizer and antihistamine that can be dosed twice a day. Immunotherapy is effective and should be offered to those who are intolerant or have allergic conjunctivitis refractory to medications.

Conjunctivitis, Allergic↗
PubMed2001

Characterization of the mycoplasmal conjunctivitis epizootic in a house finch population in the southeastern USA.

An epidemiological study of the prevalence of mycoplasmal conjunctivitis in the house finch (Carpodacus mexicanus) was conducted in Auburn (Alabama, USA) between March 1998 and February 1999. Clinical disease was observed in 4% of the 1,214 finches trapped and examined. This rate is comparable to the average annual prevalence observed in this population since 1996, although the prevalence of clinical disease observed in the peak months of September through November was lower than in previous years. Clinically ill birds were observed in all months of the study. To estimate the prevalence of recovering and asymptomatic, infected birds, we tested a subset of 334 house finches serologically for exposure to Mycoplasma gallisepticum (MG) using the serum plate agglutination (SPA) assay. The prevalence of clinical disease in this subsample was slightly higher (7%) than in the entire sample, reflecting the fact that the serological survey was initiated in the late summer when the prevalence of MG infection peaks in our study population and a sampling bias for symptomatic birds. The serological survey indicated that 13% of this subpopulation had been exposed to MG. We also tested 46 of 334 finches by polymerase chain reaction (PCR) to detect MG in seropositive, asymptomatic birds. Use of the PCR in conjunction with the SPA detected six asymptomatic, infected birds that may represent potential carriers or birds in the early stages of infection. The decreasing prevalence of clinical disease observed during the peak months suggests a changing host-parasite relationship. Continued surveillance of this population, employing both clinical observation and serological analysis will be useful in characterizing these changes over time.

Animals↗
PubMed2001

Diagnosis and treatment of conjunctivitis in house finches associated with mycoplasmosis in Minnesota.

An ongoing outbreak of Mycoplasma gallisepticum-associated conjunctivitis in house finches (Carpodacus mexicanus) that began in 1994 in the eastern United States has been spreading westward. House finches presenting with the clinical signs of M. gallisepticum-associated conjunctivitis were first seen at the Wildlife Rehabilitation Center of Minnesota (Minnesota, USA) in July of 1996, and 42 cases were admitted from 26 December 1996 to 10 August 1997. A nested PCR was designed for sensitive and specific detection of the presence of the organism. Twelve birds were treated with oral enrofloxacin (15 mg/kg, twice daily for 21 days) and ophthalmic gentamicin (twice daily for 21 days). All treated birds showed resolution of clinical signs. Following treatment, finches were held for up to 6 mo and tested for the presence of M. gallisepticum by culture and nested polymerase chain reaction (PCR). Eight of twelve finches (67%) were positive for M. gallisepticum by nested-PCR and four (33%) were positive by culture. The results suggest that oral enrofloxacin and opthalmic gentamicin are not an effective treatment for the eradication of M. gallisepticum in house finches. Further, the results show that nested PCR is an effective method for detection of M. gallisepticum in house finches and was more sensitive than culture.

Administration, Oral↗
PubMed1988

The first epidemic of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant in Okinawa, Japan, in 1985-1986.

Epidemics of acute hemorrhagic conjunctivitis due to a coxsackievirus A24 variant occurred in July-November, 1985 and August-October, 1986 in Okinawa Prefecture, Japan. This is the first report of an acute hemorrhagic conjunctivitis epidemic due to a coxsackievirus A24 variant in Japan The epidemic involved most islands of the prefecture. The prefectural surveillance center was notified of 9,952 cases in 1985 and 6,096 cases in 1986 from three sentinel eye clinics. The neutralizing antibody-positive rate against the coxsackievirus A24 variant of the serum samples collected before and immediately after the 1985 epidemic rose from 1.0% to 8.5%. The coxsackievirus A24 variant was isolated from 48 out of 68 conjunctival swabs collected during the epidemics. The isolates were indistinguishable antigenically in the plaque reduction test from the prototype strain, EH24/70, but had a markedly distinct oligonucleotide pattern.

Adolescent↗
PubMed2000

[Therapy of allergic conjunctivitis].

Among the several eye diseases (or diseases involving the eye) based on hypersensitivity reactions, the most frequent is allergic conjunctivitis. Recently six types of allergic conjunctivitis/keratoconjunctivitis are distinguished: 1. seasonal, 2. perennial, 3. vernal, 4. giant papillary, 5. atopic and 6. of contact origin. Their treatment is generally local. In the most frequent seasonal ("hay fever") and perennial forms the elimination of the allergen or when it is impossible antihistamines (with or without vasoconstrictors), "weak" steroids or hyposensitisation are offered. In vernal and atopic keratoconjunctivitis mast cell stabilizers are the most effective, with special effect of lodoxamide in the vernal type. In giant papillary and contact allergic inflammations the elimination of the causative agent is the first method of choice. In resistant cases "strong" steroids, in extreme forms immunosuppressive, cytostatic and systemic treatment may become necessary. The paper gives a review of currently applied medicines (mainly eyedrops) and other methods of treatment, and includes therapeutic principles applying to various forms of allergic conjunctivitis.

Anti-Inflammatory Agents↗
PubMed2000

Prevention of acute allergic conjunctivitis and late-phase inflammation with immunostimulatory DNA sequences.

PURPOSE: To evaluate the therapeutic potential of immunostimulatory sequence oligodeoxynucleotides (ISS-ODN) administration in ocular allergy, using a mouse model of ragweed-specific conjunctivitis. METHODS: A murine model of allergic conjunctivitis involving SWR/J mice sensitized and challenged with short ragweed was used to test immunostimulatory DNA sequences for therapeutic potential. ISS-ODN or control ODN (0.1 mg/mouse) was administered intraperitoneally or topically to the conjunctiva 3 days before final allergen challenge. Multiple parameters of clinical symptoms evident during the acute-phase reaction and the cellular components of the late-phase reaction were evaluated in both groups of mice. RESULTS: All parameters of clinical symptoms were markedly inhibited after intraperitoneal injection of ISS-ODN, whereas topical application to the conjunctiva did not inhibit clinical symptoms significantly. Remarkably, a single topical treatment with ISS-ODN (as well as by intraperitoneal injection) completely inhibited both eosinophilia and neutrophilia in the late-phase reaction. CONCLUSIONS: Systemic or conjunctival administration of ISS-ODN was shown to significantly inhibit allergic responses in this mouse model. This indicates that ISS-ODN may be an effective form of immunotherapy for this class of allergic disease.

Acute Disease↗
PubMed2000

Comparison of azelastine eye drops with levocabastine eye drops in the treatment of seasonal allergic conjunctivitis.

A randomised, multicentre parallel group study was undertaken to compare the efficacy and safety of 0.05% azelastine eye drops (101 patients) in an open manner with 0.05% levocabastine eye drops (103 patients) and in a double-blind manner with placebo (103 patients) during a 14-day treatment period involving patients with seasonal allergic conjunctivitis. The three main eye symptoms, scored on a four-point scale, were itching, lacrimation and conjunctival redness; the primary efficacy variable was the responder rate on day 3. Responders were patients whose sum score of the three main eye symptoms decreased by at least three points from a baseline score of at least six points. In addition to these main symptoms, five other symptoms were recorded on days 0, 3, 7 and 14, and patients kept daily diaries of the three main eye symptoms and swollen eyelids. The responder rate after 3 days of treatment was 69% in patients treated with azelastine, 59% in patients treated with levocabastine and 51% in the placebo group. Only the difference in responder rates between azelastine and placebo eye drops was statistically significant (p = 0.02). The improvements in other ocular symptoms and entries in the patients' diaries closely reflected the changes reported by the investigators. No serious adverse events occurred throughout the study. Nine patients (three in the azelastine, five in the levocabastine and one in the placebo group) terminated the study prematurely due to poor tolerability. Adverse drug reactions, mainly a mild, transient irritation and a bitter or unpleasant taste, were reported in 37% of patients receiving azelastine eye drops, 31% of patients receiving levocabastine and 9% of placebo patients. Overall tolerability was assessed as very good or good in 86% of azelastine- and levocabastine-treated patients, and in 95% of the patients receiving placebo. The results of this study indicate that azelastine possesses a tolerability profile at least comparable to that of levocabastine eye drops, but additionally appears to have a slightly quicker onset of effect, and confirm the therapeutic potential of azelastine eye drops in the treatment of allergic conjunctivitis.

Adolescent↗
PubMedDate not supplied

Local conjunctival immunotherapy: the effect of dermatophagoides pteronyssinus local conjunctival immunotherapy on conjunctival provocation test in patients with allergic conjunctivitis.

BACKGROUND: We evaluated the effect of local conjunctival immunotherapy (LCIT) with standardized dermatophagoides pteronyssinus (Dp) extracts on antigen-specific conjunctival provocation test (CPT) in patients with allergic conjunctivitis in a double blind, placebo-controlled study. We use the CPT because in our experience is the more objective parameter to evaluate the sensitivity to allergens in this patients. METHODS: The patients were selected on the basis of symptoms, positive prick test, positive CPT and elevated serum and tears total and specific IgE. The CPT was assessed with increased dilution of Dp extracts instilled into the lower fornix. Conjunctival hyperemia, tearing, itching, burning and swelling of eyelids were scored according a 4-point rating scale. Patients were randomly assigned to 2 groups of 12. The first group was treated with Dp extracts and the second group with placebo during 6 months. A drop of diluted antigen was instilled in both eyes daily, in 2-fold increased concentrations, the first 10 AU/ml. The maintenance dose was 1,000 AU/ml or the maximal dose which did not provoke symptoms. The symptoms were controlled with oral and/or local antihistamines. We evaluated the CPT before and after the treatment. The patients did not receive antihistamines during the 15 previous days to carrying-out the CPT. RESULTS: Ten of the twelve patients of the active group complete the treatment. One of the patients dropped out of the study because experienced local reaction with a dose of 1,000 AU/ml and refused to continue with the treatment. Other patient was disqualified for failure to comply with the protocol. One patient, which experienced itching and tearing with a dose of 1,000 AU/ml, tolerate 100 AU/ml. We continue with this dose until the end of treatment. The remaining patients tolerate 1,000 AU/ml as maintenance dose. A significant difference was observed in the score of CPT between LCIT treated patients and placebo group after 6 month of LCIT. CONCLUSIONS: We propose LCIT as a useful alternative to traditional subcutaneous immunotherapy in patients with allergic conjunctivitis.

Adolescent↗
PubMed2001

Antimicrobial sensitivity of Haemophilus influenzae isolates from bacterial conjunctivitis.

Haemophilus influenzae is one of the common bacterial pathogens which affect children. Resistance to frequently used antibiotics is becoming a significant problem in community isolates of common pathogens. A retrospective review was conducted of the serotypes and antimicrobial sensitivity of H influenzae isolates from bacterial conjunctivitis, over an 18-month period. Data on antimicrobial sensitivity (obtained by the National Committee for Clinical Laboratory Standards disk diffusion method) and beta-lactamase production, and typing results, were analysed. Ninety-nine isolates were recovered, of which 87 were typed. Most isolates were recovered from children under one year of age. Ninety-three percent were unencapsulated and biotypes I and IV were most common. H influenzae type b was recovered only twice. beta-lactamase was produced by 41% isolates while four isolates were ampicillin-resistant but did not produce beta-lactamase. All isolates were sensitive to chloramphenicol and 45% were co-trimoxazole sensitive. H influenzae is commonly isolated from bacterial conjunctivitis in Barbados and, as elsewhere, the majority of isolates are from small children and are non-encapsulated. However, there is a high prevalence of beta-lactamase production, which may serve as a reservoir for transfer to more invasive encapsulated strains of H influenzae within the oropharyngeal flora.

Adult↗
PubMed2002

Nitric oxide levels in tears of patients with mild forms of papillary conjunctivitis induced by rigid gas-permeable contact lenses.

PURPOSE: To determine whether nitric oxide (NO) is detectable in the tear fluid of patients with mild forms of papillary conjunctivitis who wear rigid gas-permeable contact lenses. METHODS: Tear samples were taken from 12 users of rigid gas-permeable contact lenses and 12 healthy controls. Samples were analyzed, and the levels of NO were determined. RESULTS: The mean level of NO in those who wore contact lenses was 118.98 micromol/L (95% CI: 91.85-146.10 micromol/L); whereas the level of NO found in the control subjects was 114.84 micromol/L (95% CI: 102.54-127.14 micromol/L). The difference was statistically insignificant (P>0.05). CONCLUSION: Nitric oxide levels in the tear fluid of rigid gas-permeable contact lens users did not correlate with the presence of mild symptoms of papillary conjunctivitis.

Adolescent↗
PubMed2001

Allergic conjunctivitis.

The purpose of this research is to study the clinical features and risk factors of various types of allergic conjunctivitis. Four hundred and forty-five patients with a history of itching, foreign body sensation, lacrimation and red eyes were examined, and a skin test was performed and assessed to grade the severity. The mean age of the subjects was 24.5 +/- 16.3 years with female preponderance, except for vernal keratoconjunctivitis. The majority of the patients had perennial allergic conjunctivitis. Ninety-five percent of the patients had associated allergic diseases, especially allergic rhinitis. Sixty-six percent of the patients had a family history of atopy. Most patients had symptoms at night. Symptoms persisted throughout the year and were generally triggered by exposure to house dust. The allergy skin tests to common aero-allergens were positive in 95% of patients tested. Common allergens causing sensitization were house-dust mites, house dust, cockroaches, and grass pollen. Environmental control and avoidance of these allergens should be stressed in the management of these conditions.

Adolescent↗
PubMed2002

Corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus in a Congolese child.

PURPOSE: To report a case of unilateral corneal hydrops associated with vernal conjunctivitis as a presenting sign of keratoconus. METHOD: Case report. A 10-year-old girl with corneal hydrops of the left eye. RESULT: Visual acuity in the affected eye was hand motions and slit-lamp examination revealed a left keratoconic, ectasis, edematous cornea with mild vernal conjunctivitis. CONCLUSION: Hereditary and environmental factors may contribute to the etiology of keratoconus and corneal hydrops.

Child↗