Conjunctival, corneal involvement accompanying erosive-ulcerative blepharitis.
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Blepharoconjunctivitis caused by methicillin-resistant strains of Staphylococcus epidermidis occurred in two hospitalized patients, a 74-year-old man and a 19-year-old man. Both strains were resistant to multiple courses of topical antibiotic therapy. Successful treatment in both cases depended upon antibiotic sensitivity testing. These methicillin-resistant strains of S. epidermidis, like methicillin-resistant strains of Staphylococcus aureus, demonstrated almost complete cross-resistance to cephalosporins despite apparent sensitivity on Kirby-Bauer disk sensitivity testing. Topical vancomycin was curative in one case. In the other case, treatment with topical gentamicin, intravenous cefoperazone, and oral rifampin led to resolution of the symptoms.
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OBJECTIVE: The objective of our study was to describe the ophthalmic features and histologic eyelid findings of Melkersson-Rosenthal syndrome. DESIGN: Three patients with eyelid edema underwent eyelid biopsy to establish the diagnosis of Melkersson-Rosenthal syndrome. RESULTS: Of the three patients, only one patient manifest the classic triad of facial edema, facial paralysis, and furrowed tongue. Histoloppgically, the eyelid skin in all patients showed characteristic perilymphatic granulomas with marked dermal edema. CONCLUSIONS: The histopathologic features assist in establishing the diagnosis of Melkersson-Rosenthal syndrome in oligo- and monosymptomatic patients. Melkersson-Rosenthal syndrome should be considered in patients presenting with eyelid edema of unknown etiology and biopsy performed.
Contact lenses should be used with caution in patients who have an ocular allergy. Patients who have seasonal allergy should avoid contact lens use during seasonal flare-ups. The need for clean lenses with minimal deposit buildup must be stressed, and the use of daily wear lenses with rigid disinfecting and cleaning techniques is recommended. Alternatively, daily disposable lenses should be used. The patient should avoid the use of topical anti-allergy agents while the lenses are in place, particularly vasoconstrictor agents. Extended wear contact lenses are contraindicated in patients who have ocular allergy. In general, the use of contact lenses is contraindicated in patients with vernal conjunctivitis. With careful attention to recognizing the patient with ocular allergy, regular monitoring, and patient compliance to lens care, successful contact lens wear can be achieved in most patients with ocular allergy.
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