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Conjunctive bias in memory representations of logical connectives.

The paper presents the conjunctive bias in memory-a novel phenomenon that helps to clarify representations of logical connectives. The conjunctive bias is a tendency toward more accurate recall and recognition of conjunctive forms than of forms based on other logical connectives and a tendency to recall and recognize other logical forms as if they were conjunctions. Three experiments, in which participants' memory representations associated with different logical connectives were examined, were conducted to test the conjunctive bias hypothesis. In Experiment 1, participants learned picture-proposition pairs involving either conjunctions or disjunctions and then had to recall each proposition when cued with its picture. In Experiments 2 and 3, recognition memory for conjunctions, disjunctions, and conditionals was examined with an old/new recognition procedure. The findings of these experiments provide evidence for the conjunctive bias. Furthermore, the results of Experiment 3 suggest that corjunctive bias is not simply a pragmatically caused preference for conjunctions. The discussion focuses on the implications of these findings for current theories of deductive reasoning.

Adult↗

Conceptual combination: conjunction and negation of natural concepts.

The operation of negation on combinations of natural categories was examined in two experiments. In the first, category membership ratings of lists of items were obtained for pairs of concepts considered individually and in two logical combinations: conjunctions (e.g., "Tools which are also Weapons") and negated conjunctions--forms of those conjunctions in which the modifier noun category was negated ("Tools which are not Weapons"). For conjunctions, results supported earlier findings of overextension and the geometric averaging of constituent membership values (Hampton, 1988b). Previous findings of concept dominance and noncommutativity within conjunctions were also replicated, both for typicality ratings and for probability of class membership. For negated conjunctions, the pattern of dominance was similar but interacted with order within the conjunction. Negated conjunctions were also overextended. The second experiment explored how the attributes of negated conjunctions were derived from those of the two component concepts. Frequency of generation of attributes expressed positively (has wheels) or negatively (has no wheels) followed rated frequency in the negated category. The distinctiveness of an attribute to distinguish the complement from the head-noun class was associated with the generation of attributes, particularly when there was relatively high overlap between the two categories.

Concept Formation↗

The conjunction effect: new evidence for robustness.

Five studies investigated the conjunction effect (or conjunction fallacy), in which participants report that the conjunction of two events is more rather than less likely than one of the events alone. There was no evidence that feedback or monetary reinforcement for correct answers affected students' performance on conjunction problems. Under some circumstances the context in which the conjunction problem was presented (after questions emphasizing logic or questions emphasizing opinions) affected occurrence of the effect. Location of the conjunction among the statements being rated had a significant effect. The effect occurred with or without a framing description and whether the conjunction consisted of two or three simple statements. However, statements representing the conjunction of three simple statements were (appropriately) judged less likely than those representing the conjunction of two simple statements. The substantial incidence of the effect, even without the descriptive frame and even when incentive and feedback were provided for correct answers, argues for its robustness.

California↗

Tear IgE concentrations in allergic conjunctivitis.

PURPOSE: Tear IgE has been considered to play an important role in allergic conjunctivitis and the measurement of tear IgE concentrations can help to diagnose this condition. Locally produced IgE levels have been shown to be the largest contributor to the severity of allergic conjunctivitis. METHODS: One hundred and thirteen allergic conjunctivitis patients (70 seasonal allergic conjunctivitis (SAC), 21 perennial allergic conjunctivitis (PAC), 22 vernal keratoconjunctivitis (VKC)), 14 bacterial conjunctivitis (BC) patients, 13 epidemic keratoconjunctivitis (EKC) patients and 18 normal controls were recruited. Tear samples were collected using the microcapillary method and tear IgE levels were measured using an immunoenzyme assay. RESULTS: Tear IgE concentrations showed significant increases in the VKC (322.2 +/- 45.7 ng/ml), SAC (194.7 +/- 21.7 ng/ml) and PAC (134.8 +/- 23.1 ng/ml) groups when compared with controls (52.1 +/- 9.7 ng/ml, p < 0.01). No significant difference was found between EKC (97.2 +/- 11.7 ng/ml) and BC (92.6 +/- 13.8 ng/ml) groups and controls (p = 0.1). CONCLUSIONS: Tear IgE concentrations showed a significant increase in allergic conjunctivitis patients when compared with controls. Our results suggest that measuring tear IgE concentrations can help to diagnose allergic conjunctivitis.

Adult↗

Schirmer tear test values and tear film break-up times in cats with conjunctivitis.

OBJECTIVES: (1) To document tear film break-up time (TFBUT) in a group of cats with conjunctivitis; (2) to determine if TFBUTs from cats with conjunctivitis vary significantly from previously established normal values for TFBUT in young cats without ocular disease; (3) to determine if a correlation exists between Schirmer tear test (STT) values and TFBUTs in cats with conjunctivitis; (4) to determine if the TFBUTs in cats with conjunctivitis are influenced by the detection of DNA from feline herpes virus-type 1 (FHV-1), Chlamydophila felis, Mycoplasma spp., and feline calicivirus. ANIMALS STUDIED: Fourteen cats between the ages of 0.8 years to 12 years with active, untreated conjunctivitis and without active keratitis or other ocular or systemic abnormalities were included in this study. Procedures Complete ophthalmic examinations, including TFBUT, were performed on all cats. Polymerase chain reaction (PCR) screening for FHV-1, Chlamydophila felis, Mycoplasma spp., and feline calicivirus was performed on conjunctival swabs from affected eyes and blood samples from all cats. RESULTS: Mean TFBUT for cats in this study was 8.9 (+/- 4.8) s in the right eye (OD) and 8.1 (+/- 4.6) s in the left eye (OS). No correlation existed between mean TFBUTs and mean STT values OD or OS. Conjunctival swabs from seven cats (n = 9 eyes) tested positive via PCR for one of the above infectious agents. Blood samples from nine cats tested positive for FHV-1. Mean TFBUTs for cats from which the DNA from FHV-1 was isolated from the blood were significantly lower than mean TFBUTs for cats from which no such DNA was isolated from the blood. CONCLUSIONS: In this study, the mean TFBUT in cats with conjunctivitis was significantly lower than previously established values for clinically healthy cats. This supports the theory that qualitative tear film deficiency, and thus tear film instability, may play a role in the pathogenesis of feline conjunctivitis. Qualitative tear film deficiency may predispose to the development of conjunctivitis or may occur secondarily to this condition.

Animals↗

Measurement of interleukin-4 and histamine in superficial cells of conjunctiva in patients with allergic conjunctivitis.

Interleukin 4 (IL-4) may play a role in the development of allergic disease. We questioned whether IL-4 related phenomenon occurred on the surface of the conjunctiva during allergic conjunctivitis. Ten patients with cedar pollen-allergic conjunctivitis and 10 patients with postsurgical conjunctivitis were enrolled in this study. Cells were collected by brush cytology from the upper palpebral conjunctiva. After the cells were cultured for 24 hours, the levels of IL-4, IgE, and histamine were measured in the supernatants. An ELISA was used for histamine and a highly sensitive sandwich ELISA for IL-4 and IgE. Conjunctival cells were also stained and fixed by May-Grunwalds stain solution. The number of superficial cells, especially lymphocytes, were compared in the two groups. The total number of cells collected by brush cytology did not differ in allergic vs., postsurgical conjunctivitis. Lymphocytes were similarly present in such specimens. The levels of IL-4 (p = 0.01) and histamine (p = 0.02) significantly increased in the specimens from patients with allergic conjunctivitis, although IgE was not detected in both groups. There was a correlation between the level of IL-4 and histamine (p = 0.0001). Conjunctival cells in allergic conjunctivitis produced a larger amount of IL-4 and histamine for cedar pollen compared to the postsurgical conjunctivitis. As with other allergic diseases, IL-4 may play a role similar to that of histamine in the development of allergic conjunctivitis.

Adolescent↗

Treatment of neonatal conjunctivitis.

The effect of different treatment regimens on clinical and microbiologic cures of neonatal conjunctivitis was evaluated during a 32-day observation period. In 84 infants with mild to moderate conjunctivitis and no signs of dacryocystitis, clinical cures were achieved in more than 50% of the cases with lid hygiene only. Staphylococcus aureus was the most common organism (48%) isolated from these infants. Chlamydia trachomatis could not be isolated from eyes with mild to moderate conjunctivitis. Forty-four infants with severe conjunctivitis, with or without dacryocystitis, were randomly assigned to treatment with either topical chloramphenicol or oral erythromycin for 14 days. Chlamydia trachomatis was isolated from 19 (43%) of these infants. All infants with chlamydial conjunctivitis who were treated with 25 mg/kg of oral erythromycin ethylsuccinate twice daily for 14 days were clinically and microbiologically cured. In contrast, all treatment of chlamydial conjunctivitis with topical chloramphenicol failed clinically as well as microbiologically. Dacryocystitis was a common complication in neonatal conjunctivitis (17%). The clinical failures in neonatal nonchlamydial conjunctivitis were associated with persistent obstruction of the nasolacrimal duct.

Administration, Oral↗

Evidence for persistence of adenovirus in the tear film a decade following conjunctivitis.

Chronic papillary conjunctivitis has been described following adenoviral conjunctivitis. It is unknown however, how long adenovirus is able to persist in the tear film and conjunctiva. To determine if adenovirus persists in the ocular surface following adenoviral conjunctivitis, 304 patients with a history of adenovirus conjunctivitis from whom an adenovirus had been isolated 10 years previously were sent a questionnaire regarding persistent or recurrent symptoms and were invited to attend. Patients were examined and samples of tears and conjunctival cells were collected from both eyes using tear film washes, filter paper, and swabs, the latter for virus isolation. Extracted DNA from the ocular samples was amplified using primers for herpes simplex virus (thymidine kinase) and adenovirus (hexon) genes. Adenovirus amplicons were sequenced and compared to original serotype. Thirty patients attended, 19 of whom had persistent papillary conjunctivitis. Evidence of adenovirus DNA was detected in 17 of 30 patients, 15 of whom also had evidence of a chronic papillary conjunctivitis. Adenovirus DNA was significantly associated with papillary conjunctivitis (P = 0.03). Adenovirus amplicons were successfully sequenced from six patients. Four patients harbored type 3 adenovirus, the same serotype with which they were infected originally 10 years previously. Two patients were infected originally with adenovirus serotype 3 but the current serotype was type 4. Infection of the ocular surface with adenovirus may predispose to the development of a persistent or recurrent conjunctivitis, the presence of which, appears to be associated with evidence of long term persistence of adenovirus DNA.

Adenovirus Infections, Human↗

Meibomian gland function and giant papillary conjunctivitis.

We examined 42 contact lens-wearing patients for clinical evidence of giant papillary conjunctivitis and for meibomian gland dysfunction with gland dropout. Fifteen patients were free of clinical signs and symptoms of giant papillary conjunctivitis, whereas 27 had clinical symptoms and evidence of giant papillary conjunctivitis. Patients with giant papillary conjunctivitis had significantly more gland dropout with an average of 0.6 +/- 1.2 gland absent in both lower eyelids compared with 0.2 +/- 0.4 gland absent in patients without giant papillary conjunctivitis. Additionally, the viscosity of meibomian gland excreta was greater in the giant papillary conjunctivitis group. There was no difference in tear osmolarity or in the Schirmer test results between the two groups. These results indicated patients with giant papillary conjunctivitis were more likely to have meibomian gland dysfunction with gland dropout than patients without giant papillary conjunctivitis.

Adult↗

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

BACKGROUND: The onset of keratoconus usually coincides with adolescence, and may be associated with vernal conjunctivitis or other atopic conditions. In patients with vernal conjunctivitis, acute hydrops may be the presenting sign of keratoconus in preadolescence. METHODS: Review of ophthalmic clinical manifestations of three children with presenting symptoms and signs of acute corneal hydrops associated with vernal conjunctivitis. RESULTS: Three children, 5 to 11 years of age, presented with corneal hydrops associated with mild vernal conjunctivitis. In two of these children, vernal conjunctivitis was asymptomatic, and in one child the signs of vernal conjunctivitis appeared after the occurrence of hydrops. No other factors, including mechanical factors such as eye rubbing, were found to be related. CONCLUSIONS: The association of vernal conjunctivitis with keratoconus may contribute to the early occurrence of hydrops. Corneal hydrops in children may, therefore, indicate coexisting vernal conjunctivitis.

Child↗

An outbreak of conjunctivitis due to atypical Streptococcus pneumoniae.

BACKGROUND: In February 2002, clinicians at the Dartmouth College Health Service recognized an outbreak of conjunctivitis; cultures of conjunctival swabs implicated Streptococcus pneumoniae. An investigation was begun to determine the extent of the outbreak, confirm the cause, identify modes of transmission, and implement control measures. METHODS: Investigators reviewed the health service's data base for diagnoses of conjunctivitis. Viral and bacterial cultures were obtained from ill students. Bile-soluble isolates that were susceptible to ethylhydrocupreine (optochin) and therefore were presumed to be pneumococci underwent serotyping, capsular staining, pulsed-field gel electrophoresis, a DNA probe, and multilocus sequence typing. A cohort study of risk factors was conducted with the use of the Internet. Control measures included distribution of alcohol-based hand gel and messages about prevention. RESULTS: Among 5060 students, 698 (13.8 percent) received a diagnosis of conjunctivitis from January 1, 2002, through April 12, 2002, including 22 percent of first-year students. Presumed pneumococci were isolated from 43.3 percent of conjunctival swabs (110 of 254); viral cultures performed on 85 specimens were negative. DNA probes and multilocus sequence typing confirmed that the organisms were pneumococci, although the bacteria did not have the characteristic capsule. On pulsed-field gel electrophoresis, strains were found to be identical to pneumococci that caused outbreaks of conjunctivitis in other parts of the country in 1980. Analysis of survey data from 1832 students indicated that close contact with a student with conjunctivitis, wearing contact lenses, membership on a sports team, and attending parties at or living in a fraternity or sorority house were associated with conjunctivitis. The rate of diagnosis of conjunctivitis declined after the implementation of control measures and after spring break. CONCLUSIONS: This large outbreak of conjunctivitis on a college campus was caused by an atypical, unencapsulated strain of S. pneumoniae that was identical to strains that had caused outbreaks two decades earlier.

Conjunctiva↗

Acute hemorrhagic conjunctivitis in Puerto Rico, 1981-1982.

In late 1981, the Western Hemisphere's pandemic of acute hemorrhagic conjunctivitis spread to Puerto Rico. Over 6,000 cases of conjunctivitis were reported to the Puerto Rico Department of Health from November 1981 to March 1982. Enterovirus 70 was isolated from one of 19 eye-swab specimens tested, and 10 of 13 (77%) individuals with acute hemorrhagic conjunctivitis had neutralizing antibody titers to enterovirus 70 of greater than or equal to 1:4. These data suggest that enterovirus 70 was the etiologic agent of the acute hemorrhagic conjunctivitis outbreak in Puerto Rico. In a study of a lower middle socioeconomic sector with relatively intense transmission, 152 of 670 (23%) persons reported illness consistent with acute hemorrhagic conjunctivitis. The highest attack rate was in the 5- to 14-year-old group (30%), and a disproportionate number of household index cases were in the predominantly school age group (5-19 years old). Twelve per cent (3/25) of asymptomatic household contacts of acute hemorrhagic conjunctivitis cases had sera with neutralizing antibody to enterovirus 70. Retrospective surveillance through ophthalmologists and neurologists identified one patient with a neurologic complication, a seventh nerve palsy temporally associated with recent enterovirus 70 infection. Household transmission was significantly associated with crowding and sharing of beds (p less than 0.05). This and other recent studies in Florida suggest that school age children play an important role in the transmission of acute hemorrhagic conjunctivitis. This study also suggests that asymptomatic enterovirus 70 infection is uncommon, and that in Puerto Rico, neurologic complications associated with acute hemorrhagic conjunctivitis were quite rare.

Adolescent↗

Epidemiology and diagnosis of hospital-acquired conjunctivitis among neonatal intensive care unit patients.

BACKGROUND: Few recent reports describe the epidemiology and risk factors for health care-associated conjunctivitis among neonatal intensive care unit (NICU) patients in developed countries. Reporting may be inaccurate in this population given that the National Nosocomial Infection Surveillance System (NNIS) definition is largely dependent on a positive culture, whereas clinical practice often consists of empiric treatment. OBJECTIVES: We describe the epidemiology of conjunctivitis among neonates in 2 level III-IV NICUs and compare the NNIS definition with our study definition: eye drainage and empiric treatment with or without a culture. METHODS: Patient demographics, clinical, device usage and conjunctivitis data collected prospectively from March 2001 through January 2003 were analyzed. RESULTS: Conjunctivitis occurred in 5% (n = 154/2935) of infants, of whom 51% (n =79) were in NICU 1 and 49% (n =75) in NICU 2. Predominant pathogens included coagulase-negative staphylococci (25%), Staphylococcus aureus (19%) and Klebsiella spp. (10%). Significant predictors of conjunctivitis included low birth weight, use of ventilator or nasal cannula continuous positive airway pressure and study year. Ophthalmologic examination was an additional predictor of infection in NICU 1. Eye examination data were unavailable for NICU 2. Only 62% of cases that met the study definition for conjunctivitis met the NNIS definition, because many infants received empiric treatment. CONCLUSIONS: Clinical conjunctivitis was associated with low birth weight and patient care factors that could lead to contamination of the eye with respiratory tract secretions. The NNIS definition failed to detect 38% of clinical infections. Consideration should be given to revising the definition of conjunctivitis for the NICU population.

Conjunctivitis, Bacterial↗

Role of interferon-gamma in a mouse model of allergic conjunctivitis.

PURPOSE: To characterize the effect of repeated topical exposure to allergen in a mouse model of allergic conjunctivitis and to determine the role of interferon-gamma (IFN-gamma) in the pathogenesis of allergic conjunctivitis. METHODS: Wild-type BALB/c mice and IFN-gamma knockout (KO) BALB/c mice were sensitized in the footpad with short ragweed (SRW) allergen and challenged topically for seven consecutive days with SRW allergen. The number of splenic CD4(+) Th2 cells was determined by flow cytometry, and the cytokine profile of CD4(+) T cells from SRW-sensitized mice was evaluated by ELISA. The role of IFN-gamma in allergic conjunctivitis was also examined by timed in vivo neutralization with anti-IFN-gamma antibody. Allergic conjunctivitis was evaluated clinically and histopathologically. RESULTS: Repeated topical challenge with SRW allergen induced allergic conjunctivitis that was characterized by lid edema, chemosis, redness, and tearing. Histopathological analysis revealed a marked conjunctival infiltrate that was predominantly neutrophils and eosinophils. IFN-gamma KO mice and normal mice treated with anti-IFN-gamma antibody displayed milder clinical symptoms of allergic conjunctivitis and a 70% reduction in the number of eosinophils that infiltrated the conjunctiva. Spleen cells from SRW-sensitized mice contained a large population of cells that expressed the Th2 surface marker T1/ST2 and produced IL-4, -5, and -10 and IFN-gamma after stimulation with SRW allergen. CONCLUSIONS: Repeated topical application of SRW allergen induces a form of murine allergic conjunctivitis that mimics the human counterpart. IFN-gamma appears to contribute to the pathogenesis of murine allergic conjunctivitis at the effector phase, but not during the initial sensitization stage.

Allergens↗

Mycoplasmal conjunctivitis in songbirds from New York.

A field study was conducted to determine the prevalence of conjunctivitis and Mycoplasma gallisepticum (MG) infections in house finches (Carpodacus mexicanus) and other songbirds common to bird feeders in Tompkins County (New York, USA). Eight hundred two individuals of 23 species and nine families of birds were captured and given physical examinations during the 14 mo study beginning in February 1998. Clinical conjunctivitis (eyelid or conjunctival swelling, erythema, and discharge) was observed in 10% (19/196) of house finches examined, and only in the winter months from November to March. Unilateral conjunctivitis was observed in 79% (15/19) of affected house finches; one case developed bilateral disease between 8 and 18 days following initial examination. Conjunctivitis was observed in a similar proportion of males and females sampled, and body condition scores and wing chord lengths were not significantly different between diseased and non-diseased house finches. Mycoplasma gallisepticum was isolated from 76% (13/17) of finches with conjunctivitis and 2% (3/168) of clinically normal house finches sampled during the study. DNA fingerprints of 11 MG isolates using random amplification of polymorphic DNA (RAPD) techniques showed no apparent differences in banding patterns over the course of the study, suggesting persistence of a single MG strain in the study population. The prevalence of conjunctivitis and MG infections declined in house finches between February/March 1998 and February/March 1999 (23% to 6%, and 20% to 5%, respectively), but only the former was significant (P < 0.05). Conjunctivitis was also observed in four American goldfinches (Carduelis tristis) and one purple finch (Carpodacus purpureus). Mycoplasma gallisepticum infection was confirmed in the purple finch, the first documented case of MG-associated conjunctivitis in this species. The purple finch isolate was similar to house finch isolates from the study site by RAPD analysis. Positive plate agglutination (PA) tests were recorded in one other goldfinch and two purple finches, suggesting exposure of these individuals to MG. Positive PA tests were also obtained from two brown-headed cowbirds (Molothrus ater) and four tufted titmice (Parus bicolor), but MG infection could not be confirmed in these cases due to lack of samples. Based on these findings, the prevalence of MG infections in hosts other than house finches appear to be low in the population sampled. There is growing evidence, however, that songbird species other than house finches are susceptible to MG infection and disease.

Animals↗

Comparison of nested polymerase chain reaction, virus isolation, and fluorescent antibody testing for identifying feline herpesvirus in cats with conjunctivitis.

OBJECTIVE: To compare nested polymerase chain reaction (PCR), virus isolation (VI), and fluorescent antibody (FA) testing to detect feline herpesvirus (FHV) in cats with naturally acquired conjunctivitis or respiratory tract disease, or both. SAMPLES: Swab and microbrush specimens from the conjunctiva and throat were taken from 46 cats, allotted to 3 groups (conjunctivitis only, respiratory tract disease and conjunctivitis, and clinically normal). PROCEDURE: Cells from microbrush specimens were digested and herpesvirus DNA was amplified, using a double round of PCR. Products were detected by use of agarose gel electrophoresis. The VI and FA tests were performed in routine manner. RESULTS: Of 16 cats with conjunctivitis only, conjunctival specimens from 8 and throat specimens from 8 were FHV positive by PCR. None had positive results of VI or FA testing. Of 15 cats with respiratory tract disease and conjunctivitis, conjunctival specimens from 13 and throat specimens from 12 were FHV positive by PCR. A conjunctival specimen from 1 cat and throat specimens from 3 cats were FHV positive by VI. A conjunctival specimen from 1 cat was FHV positive by FA testing. Of 15 clinically normal cats, conjunctival and throat specimens from 2 cats were FHV positive by PCR; neither conjunctival nor throat specimens from these cats were FHV positive by VI or FA testing. CONCLUSION: For cats with respiratory tract disease and conjunctivitis, or with conjunctivitis only, nested PCR was more sensitive at detecting FHV than was VI or FA testing. CLINICAL RELEVANCE: Nested PCR is a more sensitive test than the currently available VI and FA tests for identifying FHV in cats with conjunctivitis.

Animals↗

Cognitive conjunction: a new approach to brain activation experiments.

This paper introduces the concepts and procedures of "cognitive conjunction," a new approach to designing and analyzing cognitive activation experiments. Cognitive conjunction compliments categorical approaches such as cognitive subtraction and requires a specific form of statistical inference that involves the conjunction of several hypotheses. While cognitive subtraction studies are designed such that a pair of tasks differ only by the processing component(s) of interest, cognitive conjunction studies are designed such that two or more distinct task pairs each share a common processing difference. The neural correlates of the process of interest are then associated with the common areas of activation for each task pair. There are two main advantages of cognitive conjunction relative to cognitive subtraction. The first is that it provides a greater latitude for selecting baseline tasks because it is not necessary to control for all but the component of interest. The only constraint on selecting the baseline is that the component of interest is the only process that differs in each task pair. The second advantage is that cognitive conjunction does not depend on "pure insertion"--the assumption that the addition of an extra processing component in the activation task has no effect on the implementation of processes that are also engaged by the baseline task. The differences between the design and the statistical analysis of experiments based on cognitive subtraction, cognitive conjunction, and factorial designs are illustrated with a study of phonological retrieval. Cognitive conjunction analysis indicates that irrespective of whether subjects name words, objects, letters, or colors, there is activation of the left posterior basal temporal lobe, the left frontal operculum, the left thalamus, and the midline cerebellum.

Brain↗

A controlled trial of povidone-iodine to treat infectious conjunctivitis in children.

PURPOSE: To report the efficacy of povidone-iodine as a treatment for conjunctivitis in pediatric patients. DESIGN: Double-masked, controlled, prospective clinical trial. METHODS: In an ophthalmology clinic in a general hospital in Manila, Philippines, 459 children (mean [SD] age 6.6 [6.6] years; range, 7 months-21 years) with acute conjunctivitis were studied. Infected eyes were cultured for bacteria and underwent immunofluorescent testing for Chlamydia trachomatis. Viral conjunctivitis was diagnosed if bacterial cultures were negative and diagnostic criteria were met. Subjects were alternated to receive povidone-iodine 1.25% or neomycin-polymyxin-B-gramicidin ophthalmic solution, one drop 4 times daily in the affected eye. Ocular inflammation was evaluated daily by the family or patient and weekly by an ophthalmologist. The main outcome measures were days until cured and proportion cured after 1 and 2 weeks of treatment. RESULTS: Despite adequate statistical power (power >80% for a 1-day difference and P <.05), there was no significant difference between treatment groups regarding the number of days to cure or proportion cured at 1 or 2 weeks whether caused by bacteria or virus (P =.133-.824 for the four comparisons). After 1 week of treatment, povidone-iodine cured marginally more chlamydial infections than the antibiotic (P =.057). By 2 weeks, fewer chlamydial infections were cured than those of viral or bacterial etiology (P =.0001). The younger the patient, the faster their conjunctivitis resolved (R = 0.13, P =.013). CONCLUSIONS: Povidone-iodine 1.25% ophthalmic solution was as effective as neomycin-polymyxin B-gramicidin for treating bacterial conjunctivitis, somewhat more effective against chlamydia, and as ineffective against viral conjunctivitis. Povidone-iodine ophthalmic solution should be strongly considered as treatment for bacterial and chlamydial conjunctivitis, especially in developing countries where topical antibiotics are often unavailable or costly.

Adolescent↗