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PubMed1989

Blepharitis and the collagen eye patch.

In our practice, blepharitis is one of the more common eyelid abnormalities and one of the most difficult to treat. We introduce a new treatment that we have found to be helpful. A prospective study was devised to test its efficacy using 20 patients distributed randomly into three different treatment protocols. Our new protocol, using lyophilized collagen pads as adjunctive treatment, significantly improved results compared with controls. We had a 79% improvement in symptomatology and a 78% improvement in objective findings.

Bacterial Infections↗
PubMed1989

The role of wax and sterol esters of meibomian secretions in chronic blepharitis.

We analyzed the fatty wax esters and sterol esters found in the expressed lipid secretions of six patients from each of six clinical groups of chronic blepharitis, plus eight normal controls. Using gas liquid chromatography (GLC), 12 peaks corresponding to equivalent chain lengths (ECL) of 33.6, 35.4, 36.1, 37.3, 38.2, 39.2, 40.1, 41.2, 42.1, 43.2, 44.9 and 45.7 were found in the fatty wax esters and five peaks corresponding to ECL 19.1, 20.0, 21.1, 22.0 and 23.2 were found in the sterol esters. The clinical groups showed significant differences in several of these components. Sterol and wax esters represent the largest fraction of the total meibomian lipid secretion. The finding that the blepharitic groups exhibit biochemical differences in the distribution of these esters indicates that the esters may play a role in the disease process, perhaps by providing a preferential substrate for normal flora which we have shown to have lipolytic capabilities. The resultant de-esterification could alter the tear film and contribute to ocular irritation. In addition, the differences seen in the composition of the ester fraction of the meibomian secretion could lead to differences in melting point, which, in turn, could affect viscosity and surface tension of the tear film, leading to changes in breakup time and to secretion stagnation within glands.

Blepharitis↗
PubMed1986

Bacterial lipases and chronic blepharitis.

Eyelids and conjunctivae of 36 normal individuals and 60 patients from six clinical groups of chronic blepharitis were cultured for aerobic and anaerobic bacteria. The most common species isolated were coagulase-negative staphylococci (C-NS) and Propionibacterium acnes. All strains of these species, and all Staphylococcus aureus strains isolated were tested for the ability to break down triglycerides, cholesterol esters, and fatty waxes. Each strain was incubated independently with appropriate substrates in nutrient media. Each medium was then extracted and assayed for the presence of substrate hydrolysis products by thin-layer chromatography. The percentage of strains capable of hydrolyzing a particular substrate was determined for each individual. S. aureus was a consistent and strong lipase producer, able to hydrolyze all three substrates. P. acnes was able to hydrolyze triolein and behenyl oleate but not cholesteryl oleate. No differences were observed among groups for P. acnes or S. aureus. C-NS showed a high degree of strain variability. Eighty-three percent of C-NS strains could hydrolyze triolein, 82% behenyl oleate, and 40% cholesteryl oleate. Significant group differences were seen in the percentage of lipase positive C-NS strains isolated per individual. Patients in the mixed staphylococcal/seborrheic, meibomian seborrheic, secondary meibomitis, and the meibomian keratoconjunctivitis (MKC) groups harbored significantly more C-NS strains capable of hydrolyzing cholesteryl oleate than did normal individuals. Patients in the meibomian seborrheic, secondary meibomitis, and MKC groups harbored significantly more C-NS strains capable of hydrolyzing behenyl oleate than did normals. No group differences were seen among groups with triolein hydrolyzing C-NS strains.

Blepharitis↗
PubMed1982

Treatment of blepharitis and blepharoconjunctivitis: comparison of gentamicin-betamethasone, gentamicin alone and placebo.

At two university centres 46 patients presenting with symptomatic infective blepharitis or blepharoconjunctivitis participated in a double-blind study of a new antibiotic-steroid ointment containing gentamicin and betamethasone. There was no significant difference in response to 2 weeks of therapy between the patients treated with this ointment and those treated with either an ointment containing gentamicin alone or a placebo ointment. There was also no significant correlation between the clinical response and the results of the bacterial cultures of swabs obtained at the beginning and the end of the study. However, the patients treated with the placebo had a much higher rate of recurrence of their symptoms over a 6-week follow-up period. The patients who before treatment had associated rosacea, dry eyes and a long duration of symptoms showed a poor response to therapy.

Adolescent↗
PubMed1998

The use of ultrasound biomicroscopy in pre-operative evaluation of orbital-blepharal neoformations: report of a case.

In our study we have taken into consideration the use of ultrasound biomicroscopy (UBM) in a case of orbital-blepharal lymphoma. The advantages of this methodology, which is considered a refinement of B scan ultrasonography, compared with other instruments at present available on the market, have been described. We have tried to show how the instrument for biomicroscopic ultrasonography makes it possible to obtain images of the anterior segment of the eye in every detail; it is, therefore, capable of giving us information once only available by means of examining histopathological sections. Apart from the advantages, in this work we have also described the limits of this methodology, which in order to allow an accurate diagnosis must always be accompanied by the traditional ocular echography.

Adult↗