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Acute non-haemorrhagic conjunctivitis due to coxsackievirus A24.

Two cases of acute non-haemorrhagic conjunctivitis due to coxsackievirus A24 (CA24) are described. These are the first Australian isolates. The presentation was as a severe conjunctivitis in otherwise healthy adults who had not travelled outside Australia. The course was of short duration and self-limiting with no long-term sequelae. The isolates could not be neutralised by antiserum prepared against prototype CA24 but were identified by immune electron microscopy and complement fixation.

Adult↗

[Evaluation of astemizole in allergic conjunctivitis].

A 4 week open study was carried out to evaluate the efficacy and safety of astemizole in the treatment of allergic conjunctivitis 31 patients were included in the study. Global efficacy, with 10 mg astemizole OD, was rated good or excellent in 100% of treated patients. A marked improvement of the main symptoms was noted at day 15. No side effects whether of the anticholinergic type or of the drowsiness type, were observed during the whole study. Astemizole appears to be a particularly interesting symptomatic treatment of allergic conjunctivitis.

Adult↗

Systemic antibiotics for treatment of the conjunctivitis-otitis media syndrome.

In a private pediatric practice setting 114 episodes of conjunctivitis-otitis syndrome were treated with orally administered antibiotics. In 108 (95%) of these infections Haemophilus influenzae was isolated from the pretreatment cultures of the conjunctivae; 61 were susceptible and 47 (44%) were resistant to ampicillin by a disc diffusion technique. Six cultures grew Streptococcus pneumoniae, all ampicillin-susceptible. Symptoms of conjunctivitis disappeared in 2 to 3 days in all but one patient. Of the 48 follow-up conjunctival cultures 3 to 5 days after start of therapy, 46 grew no pathogens.

Administration, Oral↗

Study of an outbreak of epidemic conjunctivitis in Delhi in 1986.

An epidemic of acute conjunctivitis occurred in Delhi during July-September 1986. The clinical presentation in total of 350 patients were characteristic of acute haemorrhagic conjunctivitis (AHC). Bacterial cultures from conjunctival swabs were sterile in 85 out of 105 (80%) patients, virus cultures in Vero and HeLa cells were negative in 30 patients. However, conjunctival scrapes from 20/30 (66.7%) patients showed specific cytoplasmic fluorescence with enterovirus 70 (EV 70) antiserum, suggesting EV 70 to be the etiologic agent of the epidemic.

Adolescent↗

[A multicenter randomized study of fusidic acid ophthalmic gel and rifamycine eyedrops in acute conjunctivitis].

A total of 163 patients with acute, presumably bacterial, conjunctivitis were included in a randomized trial, comparing: 1% fusidic acid viscous eye drops, a new ophthalmic formulation of fusidic acid instilled twice daily with rifamycin eye drops, four times daily. Both drugs were given 7 days long. Bacterial origin of the conjunctivitis, mainly staphylococcal, was proved in 75% of the cases. Overall, at the end of the treatment, a satisfactory response, on bacteriological and clinical grounds, was recorded for 87.3 and 89.5% of the patients in the Fucidin gel and rifamycin groups respectively. 9 and 12% of the patients in each group respectively, had a clinical recurrence 15 days after the treatment. No significant difference between the groups clinically and bacteriologically was noted. Side effects, mainly burning and smarting were noted by the investigators in 8 and 11 patients treated by fusilic acid and rifamycin respectively. Two patients were taken out of the study in the rifamycin group because of allergy. The difference between the groups is not significant. The use of fusidic acid viscous eye drops as compared to rifamycin eye drops was judged significantly easier by the patients (P less than 0.02), especially because of the reduced number of applications, the lack of color, and the lase of application.

Acute Disease↗

Multicenter, double-blind, placebo-controlled trial of terfenadine in seasonal allergic rhinitis and conjunctivitis.

A multiclinic, double-blind, parallel and controlled study was conducted in the 1982 spring pollen season to evaluate and compare the effects of terfenadine, 60 mg bid with those of chlorpheniramine 4 mg tid and placebo for a treatment period of seven days in patients with seasonal allergic rhinitis and conjunctivitis. Of a total of 397 patients enrolled in the seven study centers, 345 patients were accepted for evaluation of efficacy and 393 patients for safety. The results show that based on the physicians' assessment of the overall efficacy, terfenadine was significantly superior to placebo and comparable to chlorpheniramine in the relief of allergic symptoms, with moderate to complete relief being observed in 60% (68/113) of the terfenadine-treated patients, in 60% (71/119) of the chlorpheniramine-treated patients, and in 30% (34/119) of the placebo-treated patients. The daily evaluation of severity of symptoms by the patients show that the effect of terfenadine and chlorpheniramine was evident on the first day after entry, reached a peak on the second day after entry, and persisted thereafter. Side effects were minor and infrequent in all treatment groups. There was no statistically significant difference in the incidence of sedation between the terfenadine (7.6%) and placebo (2.4%) groups whereas the incidence of sedation with chlorpheniramine (19%) was significantly higher. In conclusion, terfenadine is as effective as chlorpheniramine in the treatment of symptoms of seasonal allergic rhinitis and conjunctivitis with an incidence of sedation not significantly different from that with placebo and significantly less than with chlorpheniramine.

Adult↗

[Infectious conjunctivitis. The tear leukocyte esterase reaction (TLE) as a diagnostic aid].

Lacrimal fluid is absorbed on a cottonwool swab. This swab is pressed on the test field for leukocyte esterase on the stix. The colour change is read after exactly one minute. The sensitivity of the test is 90% and the specificity is 98% as assessed on 94 cases of infectious conjunctivitis and 439 normal individuals. The test is suitable for assessing cases of conjunctivitis in view of antibiotic therapy, control of contact lenses etc.

Conjunctivitis, Bacterial↗

Presence of anaerobic bacteria in conjunctivitis associated with wearing contact lenses.

Ten anaerobic bacterial species were found in conjunctival cultures obtained from six patients who wore contact lenses and developed conjunctivitis. In three instances the anaerobic bacteria were associated with facultative bacteria. The predominant anaerobic isolates were Peptostreptococcus species (three isolates), Bacteroides sp. (two), and Fusobacterium sp. (two). It was the practice of five of the six patients to wet their lenses with saliva. It is recommended that a culture for anaerobes be obtained from any patient who uses contact lenses and develops conjunctivitis.

Bacteria, Anaerobic↗

Giant papillary conjunctivitis from an exposed prolene suture.

We document an example of unilateral giant papillary conjunctivitis (GPC) following division of a fine-gauge prolene suture employed several months earlier to close a cataract incision. Release of surgically induced astigmatism required relaxation of the suture. The conjunctival response abated with removal of the retained suture fragments. The conjunctival reaction was biopsied and shown to be similar histopathologically to that seen in GPC associated with vernal conjunctivitis and contact lens wear.

Conjunctivitis, Allergic↗

[Actinic reticuloid and pigmented exuberant conjunctivitis. Report of case].

The authors report the case of a patient showing simultaneously actinic reticuloid (AR) and pigmented exuberant conjunctivitis (PEC), which are frequently encountered separately in the highlands of Bolivia. This pathological association could be in favour of the actinic origin of PEC, whereas for RA this origin is quite obvious. The main characteristics of PEC are described, insisting on differentiation with spring conjunctivitis. As a consequence of this association and the observation of other similar cases of PEC in the course of other photodermatoses, the authors are led to consider PEC as the only extra-cutaneous alteration up to now, and one more feature in the clinical picture of photodermatoses of altitude.

Altitude↗

Acute hemorrhagic conjunctivitis in Central America: first enterovirus epidemic in the western hemisphere.

Acute hemorrhagic conjunctivitis (AHC) is an eye infection that was first noted in 1969 and became a pandemic disease in Africa, Southeast Asia, and Japan in the 1970s. It was not noted in the western hemisphere until 1981. This report describes the clinical experience with AHC in Honduras where it was first seen in the western hemisphere. Clinical presentation includes acute onset with symptoms of foreign body sensation, burning, and photophobia. Signs include lid edema, periauricular lymphadenopathy, conjunctival injection, follicular reaction, and typically subconjunctival hemorrhages. Since AHC appears to be a very contagious conjunctivitis, it can spread rapidly and result in a high proportion of the population becoming infected. There is no known specific treatment for this disease, and containment includes increased attention to hygiene.

Acute Disease↗

Enterovirus type 70: the etiologic agent of pandemic acute haemorrhagic conjunctivitis.

A new enterovirus, now classified as enterovirus type 70, was isolated from the conjunctiva of patients with acute haemorrhagic conjunctivitis during the 1971 epidemics that occurred in Japan, Singapore, and Morocco. These epidemics were parts of a pandemic involving Africa (Algeria, Ghana, Morocco, Nigeria, and Tunisia), Asia (Cambodia, China (Province of Taiwan), Hong Kong, India, Indonesia, Japan, Malaysia, the Philippines, Singapore, and Thailand), and England during 1969-71. A representative strain from each of the three epidemic areas was studied cooperatively. The strains exhibited the physicochemical characteristics of enteroviruses. Cross-neutralization tests showed that these viruses were distinct from all known human enterovirus immunotypes, but that they were antigenically closely related. The human origin of the viruses was demonstrated by the appearance of homologous neutralizing antibodies during convalescence in patients with acute haemorrhagic conjunctivitis.

Acute Disease↗

Epidemic of acute haemorrhagic conjunctivitis in Freetown, Sierra Leone, in 1970.

Epidemiological features of the epidemic of acute haemorrhagic conjunctivitis in Freetown, Sierra Leone, in 1970, are described. On the basis of hospital figures and a House-to -House survey of 0.9% of the population it is estimated that 50-53% of Freetown's population suffered from the conjunctivitis in 20 weeks. Though no causative agent was isolated, it is supposed, on the basis of the striking similarity with other outbreaks, that the epidemic was caused by enterovirus type 70. Hospital figures, a house-to-house survey and a survey in a closed community provided evidence that man-to-man contact was the principal mode of spread.

Acute Disease↗

PPNG conjunctivitis.

The treatment regimen for penicillin sensitive gonococcal conjunctivitis in an adult normally includes parenteral penicillin, frequent ocular irrigation, and topical ophthalmic gentamicin or tetracycline ointment. However, if a conjunctivitis is caused by a beta-lactamase producing microbe such as PPNG, then different antibiotics are required: e.g., spectinomycin or cefoxitin parenterally and topical chloramphenicol. Also, whereas urethritis is frequently treated with singular injections of penicillin or spectinomycin HCI (Trobicin), cases of PPNG ocular infections require a much longer course of treatment often involving seven days of intramuscular or intravenous antibiotics.

Adult↗

An outbreak of acute conjunctivitis caused by coxsackievirus A24 in Kuala-Lumpur, Malaysia, 1978.

An investigation of an outbreak of acute conjunctivitis in Kuala Lumpur from May to August 1978 was made. A total of 2,133 cases was involved, most of whom were adult Malay males of low income status from the surrounding villages and low-cost flats. The majority of cases had bilateral conjunctivitis with clear discharge. Pain and subconjunctival haemorrhage were not common and recovery, mostly without complications, occurred within 1 week. Eye scrapings and paired sera specimens were examined and the causal agent was found to be Coxsackievirus A24 (CA24).

Acute Disease↗

Primary meningococcal conjunctivitis followed by meningitis and septicemia.

One case of meningococcal conjunctivitis followed by meningitis and septicemia with fatal outcome is described. Primary meningococcal conjunctivitis is rare, but 10% of the published cases are complicated by systemic infection. It is recommended that these patients be given both local and parenteral treatment. The value of culturing the purulent exudate from the conjunctival sac to reach an etiological diagnosis is pointed out.

Adolescent↗

Treatment of acute gonococcal conjunctivitis.

Because of the remarkable increasing incidence of gonorrhea, there is danger that gonococcal conjunctivitis also will increase. The ability of the gonococcus to rapidly cause corneal destruction and become increasingly resistant to penicillin make it imperative for ophthalmologists to keep up to date on effective treatment methods. A treatment schedule for acute gonococcal conjunctivitis is presented.

Adolescent↗

Chronic ulcerative conjunctivitis in a patient with alpha-1-antitrypsin deficiency.

A 62-year-old woman had chronic bilateral conjunctival ulceration of the palpebral and bulbar conjunctivae. Conjunctival scrapings for viral, chlamydial, and bacteriologic studies were unrevealing. A conjunctival biopsy specimen was taken and submitted for histopathologic and immunofluorescent studies. Hematoxylin-eosin-stained tissue sections showed lymphocytes, plasma cells, and eosinosphils. Laboratory findings showed serum alpha-1-antitrypsin deficiency. alpha-1-Antitrypsin has a molecular weight of approximately 60,000 and inhibits a number of proteolytic enzymes including cellular trypsin, elastase, collagenase, and proteases. The deficiency of alpha-1-antitrypsin may have caused such enzymes to perpetuate the tissue damage, thus eventuating in chronic ulcerative conjunctivitis. The association of deficient alpha-1-antitrypsin with chronic ulcerative conjunctivitis could thus have been coincidental or a contributing factor to the conjunctival disease.

Conjunctival Diseases↗