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PubMed1987

A decade of PPNG in Singapore.

It has been more than 10 years since PPNG was first diagnosed in Singapore. Since then the prevalence of PPNG has increased progressively, and is now maintained at between 30 to 35% of all gonococcal infections inspite of a decrease in the overall incidence of gonorrhoea in Singapore. PPNG infections have been recorded with all forms of complicated gonorrhoea including pelvic inflammatory disease, ophthalmia and disseminated gonococcal infection. Penicillin alone cannot be used to treat gonorrhoea. The use of antibiotics active against PPNG and NPPNG both in uncomplicated and complicated gonorrhoea as first-line therapy is now essential. The medical cost of treatment of gonorrhoea has increased by 100 to 200% as a result of the emergence of PPNG.

Cephalosporins↗

PubMed1986

Childhood blindness from corneal ulceration in Africa: causes, prevention, and treatment.

Corneal scarring is responsible for approximately 70% of blindness in children in African countries. Recent studies confirm that measles infection is a common predisposing factor and that vitamin A deficiency is responsible for the majority of bilateral corneal ulceration. Herpes simplex keratitis (caused by human (alpha) herpesvirus types 1 and 2), ophthalmia neonatorum, and the use of traditional eye medicines also constitute significant causes of corneal ulceration in children in Africa. Intervention strategies, the management of corneal ulceration in children, and areas for future investigation are discussed.

Africa↗

PubMed1987

Evisceration techniques.

Evisceration is the removal of the intraocular contents of the globe. I favor evisceration with retention of the cornea when at all possible. Surgical techniques for evisceration with and without keratectomy are discussed. A promising new implant material, hydroxyapatite, is described. The outstanding advantage of this material is its transformation into "living tissue." Although extremely rare, evisceration can be associated with postoperative sympathetic ophthalmia in the remaining eye.

Anti-Bacterial Agents↗

PubMed1985

Contralateral hearing loss following inner ear injury: sympathetic cochleolabyrinthitis?

Acoustic tumor surgery provided an ideal model in which to study possible contralateral hearing loss following a destructive surgical procedure on the inner ear. Follow-up audiometric studies were performed on patients with unilateral acoustic tumors who had undergone resection of their tumors. Patients who had obvious causes for contralateral hearing loss, such as chronic otitis media, unrelated otologic surgery, and noise-induced hearing loss, were excluded from this patient population. A total of 380 patients had available pre- and postoperative audiograms. A mean air-conduction threshold (500, 1000, 2000 Hz) of greater than or equal to 20 dB was considered a significant hearing loss. After adjusting these losses for presbycusis, 1.3% of these patients still had a significant contralateral hearing loss. We discuss the possible causes for the development of contralateral hearing loss and examine the possibility that, following surgical manipulation and injury to the inner ear, immunocompetent cells become sensitized to previously unseen inner ear antigens, setting the stage for contralateral inner ear dysfunction. The similarities of this condition to sympathetic ophthalmia are discussed.

Adult↗

PubMed1985

[Periodic uveitis in horses].

The aetiology, clinical symptoms and treatment of equine periodic ophthalmia are discussed. Particular attention is paid to the possible role in aetiology of Onchocerca cervicalis microfilariae. Corticosteroids and atropine are the most important therapeutic drugs.

Acute Disease↗

PubMedDate not supplied

Chlamydial infections.

Chlamydiae are among the most successful bacterial pathogens, and there are few branches of medicine on which chlamydial infection and its sequelae do not impinge. Chlamydia trachomatis is responsible for many million cases of blindness, pelvic inflammatory disease, urethritis, epididymitis, infertility and ectopic pregnancy annually; it also causes lymphogranuloma venereum, reactive arthritis, ophthalmia neonatorum and infantile pneumonia. C. pneumoniae is among the most common causes of community-acquired pneumonia, and recent evidence suggests that it may play a part in the pathogenesis of coronary heart disease. C. psittaci is a highly prevalent zoonotic infection with a wide host range. It is of great economic importance, and causes sporadic but sometimes devastating disease in humans. Most chlamydial infections are subclinical, but even if the initial illness is mild there may be serious long-term sequelae. It is therefore important to identify and treat chlamydial infections in their early stages, but diagnosis usually depends on laboratory tests. Recent trials have shown that single doses of the long-acting macrolide azithromycin are effective in the treatment of genital and ocular C. trachomatis infection, but longer courses of antimicrobials remain the mainstay of treatment for C. pneumoniae and C. psittaci infections.

Chlamydia Infections↗

PubMed1994

[War injuries of the eye and post-traumatic glaucoma].

The authors present a problem secondary posttraumatic glaucoma caused by perforative eye injuries or contusions of the eyeball. Posttraumatic glaucoma after perforative injuries appears in high percentage 25-67%, with the postcontusion glaucoma is rare, and appears in 2-5% cases. It can appear near after injury but also after 10 years. This type of glaucoma has specific clinic finding, inversive type of tonometry, curve, retention type of curve and long interval without rise intraocular pressure. Prognosis of this glaucoma is very difficult and unsure. Most cases finish with blindness and enucleation because of the constant torpid inflammation, pains and danger of sympathetic ophthalmia. Prevention is in early microsurgery and reconstructive treatment of wound and correct conservative treatment of postcontusion glaucoma.

Eye Injuries↗

PubMed1993

Antimicrobial susceptibility pattern of Neisseria gonorrhoeae in western Austria.

From January to October 1992 24 Neisseria gonorrhoeae isolates from clinical specimens were collected at the Federal Public Health Laboratory in Innsbruck (Austria) and screened for resistance to penicillin G, erythromycin, tetracycline, spectinomycin, ceftriaxone, cefuroxime, ciprofloxacine, and silver nitrate. Patients originated from the Austrian provinces Salzburg, Tirol, and Vorarlberg, and presented with manifest gonorrhoea. Two of 24 isolates were penicillinase-producing N. gonorrhoeae. Both strains were isolated from men who had just returned from Thailand or Kenya. The isolate from Africa was also resistant to tetracycline. Five of 24 infections were acquired abroad, sex tourism being involved in four cases. The antimicrobial resistance pattern found in gonococci in western Austria revealed that topical silver nitrate and erythromycin are equally acceptable for use in prophylaxis of neonatal ophthalmia. Penicillin is still the drug of choice in the treatment of endemic infections. If gonorrhoea has been acquired abroad, especially in Asia or Africa, ceftriaxone, spectinomycin or ciprofloxazine are recommended for therapy.

Adolescent↗

PubMedDate not supplied

The Vogt--Koyanagi--Harada syndrome in children.

Two cases of the Vogt--Koyanagi--Harada syndrome in children, a very rare disorder in this age group, are reported; one patient had the chronic diffuse type, and the other had neurologic symptoms and exudative retinal detachments. Various theories of causation of the syndrome have been proposed, including viral infection, sympathetic ophthalmia, and altered immunologic status, but the etiology remains obscure.

Age Factors↗

PubMed1997

Eye injury from tarantula.

BACKGROUND: Tarantulas have become increasingly popular pets. Typically, owners are unaware of the potential risk of ocular injury from the barbed urticating (vascular reaction of the skin associated with itching) hairs found on the dorsal aspect of a tarantula's abdomen. CASE REPORT: A 22-year-old man experienced a red eye with excruciating pain after handling a tarantula. On examination, slitlamp biomicroscopy revealed approximately 30 to 40 barbed tarantula hairs in the conjunctiva, penetrating all layers of the comea. These foreign bodies were causing pain, conjunctival injection, and an anterior chamber reaction. The patient's condition was diagnosed as ophthalmia nodosa and was effectively treated with topical corticosteroids. RESULTS: Patients who manifest red eye and pain after handling a tarantula should be examined to determine if offending barbed hairs are present in the cornea and conjunctiva. To obtain a correct diagnosis, a detailed case history and careful slit-lamp biomicroscopy must be performed.

Administration, Topical↗

PubMed1976

Fluorescein angiography in syphilitic retinal vasculitis.

A case of ocular syphilis with severe ischemic retinopathy, rubeosis iridis and secondary glaucoma is described. Fluorescein angiography revealed a complete blockage of all the vessels around the macula, with dye leakage from numerous bifurcations of veins and an infiltrative mass in the macular area of both eyes. Combined treatment with steroids and penicillin brought no improvement in this condition of severe, ischemic ophthalmia.

Adult↗

PubMed1998

[Structure of occupational morbidity in St. Petersburg].

Disorders caused by physical overstrain and physical factors prevail in occupational morbidity structure in St. Petersburg, covering the shares of 49% and 24% respectively. Pulmonary diseases caused by dust are rare (7%). Strong evidence is that these data fail to depict actual prevalence of disease caused by dust in the city. Some acute and chronic occupational diseases (electric ophthalmia, rhinitis, laryngitis, conjunctivitis) are put into official registers rarely. The highest number of occupational diseases caused by physical overstrain are seen at various machinery enterprises, in building industry and construction materials production.

Humans↗

PubMed1998

Ocular sequelae of BB injuries to the eye and surrounding adnexa.

BACKGROUND: BB injuries continue to be one of the most common causes of severe ocular injury among adolescent males. Extraocular and nonperforating anterior globe injuries most commonly result in favorable visual outcomes. The appropriate medical management of both perforating and nonperforating anterior globe injuries resulting from BB trauma and their potential ocular sequelae are reviewed. CASE REPORTS: Three cases illustrating typical as well as atypical anterior globe injuries caused by BBs are presented. Two cases involve nonperforating anterior globe injuries--one with intracranial and one with intraorbital involvement. The third involves a retained intraocular foreign body. The biomicroscopic and ophthalmoscopic features of these injuries are discussed, as are potential complications and management strategies associated with these types of trauma. CONCLUSIONS: Injuries associated with intraocular BBs often result in enucleation if functional vision is not salvageable. Sequelae to such injuries include endophthalmitis, traumatic hyphema, ocular siderosis, and sympathetic ophthalmia. Plain-film radiography and axial computed tomography are critical first steps in determination of the position of any intracranial or intraorbital metallic foreign body. Routine observation for the development of ocular sequelae resulting from retained intraocular, intracranial, and intraorbital BB injuries is recommended.

Adolescent↗

PubMed1998

Perinatal infections--problems in developing countries.

The transmission of infections from the biologic mother to her offspring is popularly known as perinatal infection (PI). It is not synonymous to infections during the perinatal or neonatal period. Physicians should avoid focusing attention only on the TORCH agents in the evaluation of suspected PI. Perinatal period begins from 28 weeks of gestation. Would one consider in utero infections in the first or second trimester of pregnancy as PIs? Developing countries have difficulty in collecting reliable and accurate data of PIs. These data are useful to define the magnitude of the problems, to monitor the trends, to recognise the mode of spread, and to find a solution of PIs. Most PIs are asymptomatic and diagnosis is extremely difficult. Developing countries need rapid, easy-to-operate, simple, and cheap diagnostic tools urgently. Access to health care in the remote city is limited. Newer drugs are too expensive and very few patients can benefit from these. Each developing country should prioritize its PI problems and tackle those that have serious public health problems and socio-economic impact. Most developing countries should focus on HIV (human immunodeficiency virus) and HBV (hepatitis B virus) infections. Other countries where ophthalmia, malaria or tuberculosis are prevalent or endemic, should focus on these. Developing countries are more willing to allocate the budget for prevention of diseases than for treatment. There may be problem of promulgating the information on prevention of diseases because of illiteracy, multi-lingual community. Vaccines where available, should be affordable. Other effective prevention guidelines should be workable in poorer nations. The government should play an important role in enforcing immunisation program by intensive promotion program or by legislation.

Developing Countries↗

PubMed1965