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PubMed2000

Corynebacterium pseudodiphtheriticum keratitis and conjunctivitis: a case report.

A case of keratitis and conjunctivitis in an 86-year-old man caused by Corynebacterium pseudodiphtheriticum is reported. Corynebacteria are uncommon causes of ocular surface infections. However, the presence of corneal and conjunctival epithelial defects in an immunocompromised patient can result in severe infection by a commensal organism such as C. pseudodiphtheriticum. The significance of a positive culture in these settings should not be overlooked.

Abscess↗
PubMed2003

Supplementation of fexofenadine therapy with nedocromil sodium 2% ophthalmic solution to treat ocular symptoms of seasonal allergic conjunctivitis.

PURPOSE: Ocular symptoms are often under-treated in patients with allergic rhinoconjunctivitis. The efficacy of fexofenadine hydrochloride 60 mg capsules supplemented with nedocromil sodium 2% ophthalmic solution was evaluated to determine the optimal drug regimen for control of ocular allergic symptoms. METHODS: In this 5-week, open-label, randomized, multicentre comparative study, 89 patients with documented ragweed pollen allergy received fexofenadine b.i.d. with nedocromil rescue, fexofenadine q.d. with nedocromil b.i.d., or fexofenadine rescue with nedocromil b.i.d. during the ragweed pollen season. RESULTS: For all regimens, mean symptom severity scores for itching, burning, tearing, redness, grittiness, discharge, light sensitivity and swelling improved significantly (P < 0.003). Similarly, all groups experienced significant (P < 0.02) improvement in all clinical signs: erythema, oedema, discharge, conjunctival injection and conjunctivitis, as well as quality-of-life scores (P < 0.0001). All regimens reduced overall symptom severity scores after 5 min (P < 0.05) with relief persisting over 12 h (P < 0.03). Improvements in mean symptoms, signs and quality-of-life scores were similar among the treatment groups as were onset and duration of action even though patients in two of the three study arms were taking one-half or less of the recommended fexofenadine dosage. Patients and physicians judged the regimens containing lower fexofenadine dosages (with nedocromil b.i.d.) to be more effective overall than the regimen containing the highest fexo-fenadine dosage (with nedocromil as rescue only). CONCLUSIONS: Supplementation of oral fexofenadine therapy with nedocromil sodium 2% ophthalmic solution relieves ocular symptoms of seasonal allergic rhinoconjunctivitis, allowing control of rhinal symptoms with half the recommended dosage of fexofenadine.

Adolescent↗
PubMed2005

Congenital hydrocephalus as a rare association with ligneous conjunctivitis and type I plasminogen deficiency.

Severe type I plasminogen deficiency is the underlying cause of ligneous conjunctivitis (LC). Furthermore, pseudomembranes may also be found on other mucous membranes (gastrointestinal tract, bronchial system, genital tract). In very rare cases, congenital hydrocephalus has been associated with the more severe forms of the disease and may even precede LC. The pathophysiological mechanism is unclear at present. It is advisable to look for plasminogen deficiency in patients with congenital hydrocephalus, because obstruction of ventriculoperitoneal shunts is possible when such a condition is overlooked. Here, we report a case of LC with hydrocephalus. This report reemphasizes the association of LC with hydrocephalus which is not well known.

Cerebral Cortex↗
PubMed2006

[Povidone-iodine for treatment of adenoviral conjunctivitis: an in vitro study].

BACKGROUND: Adenoviral conjunctivitis causes high socioeconomic costs due to high contagiousness and therefore the need for extended quarantine. To date the only potentially active, topical antiviral agent is povidone-iodine (PVI). The aim of this study was to investigate the effect of diluted PVI on free adenovirus and adenoviral infected cells as well as to evaluate the cellular toxicity of PVI on non-infected cells. MATERIAL AND METHODS: PVI was diluted to a final concentration of 0.0008 %. Virucidal activity was measured IN VITRO using adenovirus 8 and A549 human epithelial cell cultures. Cytotoxicity effects on healthy cells after short- and long-term exposure to diluted PVI were measured in A549 cell cultures. RESULTS: Exposure to PVI at a concentration of 1:10 (0.8 %) completely extinguishes infectivity of free adenovirus after an exposure time of 10 minutes. PVI is less effective against intracellular adenovirus resulting in a decreased infectivity and viral activity for approximately one day with a narrow spectrum between toxicity and virucidal activity. Healthy epithelial cells can be exposed to PVI for up to 6 hours without a cytotoxic effect. CONCLUSIONS: PVI is highly effective against free adenovirus but less effective against intracellular adenoviral particles in already infected cell. Short- and long-term exposure of PVI causes little cytotoxicity for healthy cells. Therefore, administration of diluted PVI at a concentration of 1:10 is a potential option to reduce contagiousness in cases of adenoviral infections.

Adenoviridae↗
PubMed1999

[Dermatitis and conjunctivitis after contact with Euphorbia myrsinites (wolf's milk extract)--a case report].

BACKGROUND: Fresh sap of euphorbiaceae leads to a toxic burn of the skin and the eyes. Since years the sap of euphorbiaceae has been used in the treatment of different kinds of verrucas. PATIENTS: After contact with the sap of Euphorbia myrsinites three children developed a toxic dermatitis. In addition, the youngest girl showed a conjunctivitis and an occlusion of the right eye. Phorbolesters are considered to be responsible for the toxicity of the euphorbiaceae. All three children have resulted in a restitutio ad integrum. CONCLUSION: This case report is demonstrating the danger of toxic burn of this kind of plant.

Administration, Topical↗
PubMed1997

[Antazoline/tetryzoline eyedrops in comparison with levocabastine eyedrops in acute allergic conjunctivitis].

BACKGROUND: Allergic conjunctivitis is one of the most frequent allergic diseases of the anterior eye segment. METHODS: This multicentre, clinical trial was an investigation to compare the antiallergic efficacy, local tolerance and safety of Antazolin/Tetryzolin eye drops and Levocabastine eye drops. 69 patients were treated over a 2 weeks course of therapy. The subjective and objective ocular symptoms were documented over the treatment period. RESULTS: Both eye drops reduced subjective and objective ocular symptoms effective. The difference between the treatments (p = 0.0395) was the faster onset of action of Antazolin/Tetryzolin 30 minutes after administration of the first drop of trial medication. CONCLUSION: A fast and effective onset of action is of high clinical relevance. Therefore the benefits of using Antazolin/Tetryzolin eye drops was clearly outweigh.

Acute Disease↗
PubMed1986

[Clinical evaluation of N-acetylaspartylglutamic acid eyedrops in subacute and chronic atopic conjunctivitis].

Patients with subacute and chronic atopic conjunctivitis who were treated for at least one year with topically applied 2% sodium cromoglycate 4 times daily were switched to N.A.A.G.A. 6% eye drops for 2 months. A statistically significant gain in treatment effect as assessed objectively (+12.25%) and subjectively (+25.90%) was obtained. This effect could be the result of a more effective antiallergic action of N.A.A.G.A. or could be related to a relative tachyphylaxis to sodium cromoglycate.

Adolescent↗
PubMed1981

[Cryotherapy in vernal conjunctivitis].

Twenty five patients (mostly boys between the ages of nine and 14) suffering from vernal conjunctivitis were treated by cryotherapy. Three cryocycles, each of one to two minutes' duration, consisting in contact freezing at -160 degrees C, were performed under local anesthetic. There was very rapid regression of the acute inflammatory symptoms within a few days. At the same time, the eosinophil count in the smear preparation decreased considerably. The "cobblestones" only flattened out in the course of several weeks, following repeated sessions.

Adolescent↗
PubMed2003

Tear eotaxin levels in giant papillary conjunctivitis associated with ocular prosthesis.

PURPOSE: To examine the role of eotaxin and eosinophil recruitment in the immunopathogenesis of ocular prosthesis-associated giant papillary conjunctivitis (GPC). METHODS: The tear eotaxin level was measured in 68 eyes with GPC, the fellow eyes of the GPC patients, and 22 normal subjects, using an ELISA method. Upper tarsal conjunctival specimens harvested from 18 patients with GPC were examined by light microscopy. RESULTS: There was no significant difference in tear eotaxin levels between patients with GPC and healthy subjects. In patients with chronic GPC, the tear eotaxin levels were significantly lower. These eyes also had decreased conjunctival cellularity and increased fibrosis in the substantia propria. Biopsy specimens showed infiltration of lymphocytes and mast cells, but no eosinophils were found. CONCLUSION: Eotaxin and eotaxin-mediated eosinophil recruitment do not seem to have a major role in the immunopathology of chronic GPC associated with an ocular prosthesis.

Adult↗
PubMed1999

Role of tear inflammatory mediators in contact lens-associated giant papillary conjunctivitis in soft contact lens wearers.

Contact lens-associated giant papillary conjunctivitis (CL-GPC) caused by mechanical and immune mechanisms is a significant problem resulting in contact lens intolerance and discontinuation of contact lens wear. In the present study, tear fluid leukotriene C4 (LTC4) level was evaluated in soft contact lens wearers with and without CL-GPC using ELISA. Statistical analysis showed no significant difference in tear fluid LTC4 between contact lens wearers without GPC and normal controls (p>0.05), but a significant increase in tear LTC4 level in CL-GPC patients (p<0.05). On the basis of this finding, it might be possible to explain redness, conjunctival edema, increased mucoid secretion, and papillary changes by the effect of LTC4 on eye tissues. Effective treatment of CL-GPC might be possible in the future by employing inhibitors of leukotriene synthesis and action.

Adult↗
PubMed2004

Economic and quality-of-life impact of seasonal allergic conjunctivitis in Oxfordshire.

PURPOSE: The purpose of this study was to examine the economic and quality-of-life (QoL) impact of seasonal allergic conjunctivitis (SAC) from the individual patient perspective. SETTING: The study population was drawn from the general public of Oxfordshire, England. METHODS: Participants were recruited from either general practices or the casualty department of the Oxford Eye Hospital (OEH). All persons who were between 16 and 80 years of age and English speaking were eligible for enrollment in the study. The inclusion criteria for cases was that participants: 1) experienced itchy, bloodshot and watering eyes at some time between February and August every year since 1999, and 2) considered it likely that this was in response to seasonal allergens. Controls were drawn from the same sources and were age- and sex-matched to cases. Participants completed the EQ-5D Health Questionnaire, the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), the National Eye Institute (U.S.) Visual Functioning Questionnaire 25 (VFQ-25), and a specially developed Health Economic and Demographic Questionnaire. RESULTS: Most participants in both groups were female (67.5% in the SAC and 70% in the control group, P=0.565). Weekly earnings were lower in the SAC group (P<0.001), as the SAC group also worked fewer hours per week (P<0.001). Participants with SAC also experienced a greater degree of pain and discomfort as measured by the EQ-5D (P=0.018) and a lower perception of health using the EQ-VAS (P=0.039). Statistically significant differences between both groups were detected in all domains of the VFQ-25, except general and colour vision, although the differences were thought to be clinically significant only for the ocular pain domain. The RQLQ scores were also all found to differ significantly between groups (P<0.001). The total of both the public health care and private out-of-pocket costs of SAC in our study population ranged on average between pound sterling 64.61 for a pensioner to pound sterling 123.69 for a person with SAC in paid employment. CONCLUSIONS: SAC is a costly, highly prevalent, chronic condition associated with significant reductions in both ocular and general quality of life, as well as ongoing out-of-pocket expenses and health care costs. Medications that reduce this demand on health care systems and out-of-pocket expenses by patients could be of potential importance in reducing the overall economic and health burden of illness posed by SAC.

Adolescent↗
PubMed2002

Rapid response to a conjunctivitis outbreak: the use of technology to leverage information.

When an outbreak of conjunctivitis was identified at a rural New England college early in 2002, the college health center medical staff used various information management and communication systems to alert the community to the situation. They called upon the state Department of Human Services and the Centers for Disease Control and Prevention to help them understand and manage the outbreak. Technological systems already in place at the college allowed for rapid collection of data by means of a survey delivered over the Internet and a carriage study facilitated by a Web-based appointment and communication system. Within days, the data were collected and analyzed and an immediate response to contain the outbreak was launched.

Adult↗
PubMed2004

Conjunctivitis associated with Mycoplasma genitalium infection.

Conjunctival and first-void urine specimens from a patient with unilateral conjunctivitis and urethritis were found to be positive for Mycoplasma genitalium but negative for Chlamydia trachomatis, by polymerase chain reaction analysis. Identical M. genitalium DNA sequences were found in both types of specimens.

Adult↗
PubMed2003

Effects of nonsteroidal anti-inflammatory drugs on experimental allergic conjunctivitis in Guinea pigs.

The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on experimental allergic conjunctivitis, induced by ocular challenge with antigen in actively sensitized guinea pigs, were investigated. NSAIDs reduced the increase in prostaglandin D2 (PGD2) and E2 (PGE2) in the ocular lavage fluid. The inhibition of NSAIDs to these increases was approximately 90%-95%. NSAIDs also lowered itch-scratch response (ISR) to approximately one-third to one-half of the vehicle-treated group. However, these drugs scarcely affected plasma exudation in the conjunctiva. Ketotifen, an H1 histamine receptor antagonist, inhibited both pathophysiological changes (inhibition: 70%-80%). However, this drug was less efficacious than NSAIDs in reducing PGD2 and PGE2 levels. Moreover, topical administration of histamine induced ISR and plasma exudation; in contrast, PGD2 induced ISR exclusively. These results suggest that a part of antigen-induced ISR may be attributable to PGs. However, PGs may not play a key role in plasma exudation; other mediators such as histamine may be involved.

Administration, Topical↗
PubMed2006

Pharmacokinetic analysis of platelet-activating factor in the tears of guinea pigs with allergic conjunctivitis.

PURPOSE: The aim of this study was to examine the levels of platelet-activating factor (PAF) and lyso-PAF in tears from experimental animals developing allergic conjunctivitis (AC). METHODS: AC was induced in guinea pigs by application of ovalbumin in eye drops. Tear samples were collected from 5 actively sensitized animals and from 5 unsensitized control animals before the challenge, and 1, 2, 4, and 6 h postchallenge. C18:0-PAF, C18:0-lyso-PAF, C16:0-PAF, and C16:0-lyso-PAF levels in the tear samples were determined using liquid chromatography-tandem mass spectrometry. RESULTS: The concentrations of C16:0-PAF, C16:0-lyso-PAF, and C18:0-lyso-PAF were measurable in both unsensitized and sensitized groups, whereas C18:0-PAF was undetectable in tear samples from either group. The levels of C16:0-PAF, C16:0-lyso-PAF, and C18:0-lyso-PAF in sensitized animals increased throughout the time course of the experiment, whereas there was no corresponding increase in the levels of these molecules in the unsensitized group. There were strong correlations between the concentrations of C16:0-PAF and C16:0-lyso-PAF, both in the sensitized and in the unsensitized group, and the concentrations of C16:0-lyso-PAF and C18:0-lyso-PAF within each group. CONCLUSIONS: The data from this study demonstrated that the levels of PAF and lyso-PAF increase in tears in a guinea pig model of AC development and implicate a role for PAF for the development of AC.

Animals↗
PubMed1976

Radiculomyelitis following acute haemorrhagic conjunctivitis.

The clinical manifestations and natural history of radiculomyelitis following a newly reported disease--acute haemorrhagic conjunctivitis (AHC)--have been studied in 33 patients in Taiwan, and the following observations made: All the patients in this series were adults at ages ranging from 21 to 55 years; the salient initial neurological manifestations were radicular pains and acute flaccid paralysis which developed from five to thirty-seven days after the onset of AHC. In some patients, signs and symptoms indicating involvement of the meninges, cranial nerves and the white matter of the cord were observed; motor paralysis was the most striking feature during the whole clinical course; it consisted of flaccid asymmetrical weakness in one or more limbs, usually being more severe in the lower limbs than in the upper, and often more proximal than distal. Atrophy in the severely affected muscles usually became apparent in the second or third week of the weakness; the prognosis regarding the return of function in the affected muscles was dependent on the severity of the involvement. Permanent incapacitation due to paralysis and muscular atrophy in the affected proximal muscles of lower limbs was the main sequel in severe cases. The pattern and prognosis of flaccid motor paralysis were reminiscent of acute poliomyelitis in which the anterior horn cells of the spinal cord are mainly involved. Pleocytosis ranging from 11 to 270 per mm3 was noted in the majority of the patients when the cerebrospinal fluid was examined within the first three weeks from the onset of neurological symptoms; the total protein level was raised invariably from the second week onwards in all specimens, and remained so throughout the subsequent course as long as the seventh week or later. Tissue culture neutralization tests were performed on the sera from 9 patients; significant rises in the antibody titres (greater than or equal to 1:16) to AHC virus antigens were found in 8 cases, and in 2 of them a fourfold rise in the paired sera was noted. The differentiation of this syndrome from poliomyelitis and from Guillain-Barré syndrome, the relative freedom of children from neurological complications of AHC and the aetiological relationship of AHC virus to the syndrome have been discussed. It is concluded that this unusual neurological syndrome is caused by the neurovirulent properties of the AHC virus.

Adenoviruses, Human↗
PubMed1993

Disseminated microsporidiosis due to Encephalitozoon hellem: pulmonary colonization, microhematuria, and mild conjunctivitis in a patient with AIDS.

Four genera of microsporidia have been associated with disease in humans, which predominantly affects immunocompromised persons. Systemic infection with a newly characterized microsporidian species, Encephalitozoon hellem, was recently reported in a patient with AIDS. This article describes a second patient with AIDS and disseminated E. hellem infection. In this case the parasite was detected in sputum, urine, and conjunctival swab specimens. Apart from recurrent mild conjunctivitis and asymptomatic microhematuria, the patient had no findings or symptoms that could be related to this parasite. Specifically, no microsporidian-associated pulmonary pathology was documented. Detection of E. hellem in the patient's sputum may have epidemiological implications in that this finding suggests transmission of microsporidia by the aerosol route. Because the patient died of unrelated complications, it remains unknown whether he was an asymptomatic carrier of microsporidia or whether microhematuria heralded early microsporidian disease, with the onset of cellular damage in the urinary tract.

AIDS-Related Opportunistic Infections↗