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Trimethoprim-polymyxin ophthalmic solution versus chloramphenicol ophthalmic solution in the treatment of bacterial conjunctivitis.

Forty patients with a diagnosis of presumptive bacterial conjunctivitis were treated with either trimethoprim-polymyxin or chloramphenicol ophthalmic solutions in a randomized, double-blind trial. No significant differences could be demonstrated between the results of 7-days' treatment with the two preparations and both solutions were found to be effective in improving the signs and symptoms of surface ocular bacterial infection. No adverse reactions were reported in either treatment group.

Adolescent↗

Immunofluorescence test for the epidemiological monitoring of acute haemorrhagic conjunctivitis cases.

An epidemic of acute haemorrhagic conjunctivitis (AHC) occurred in and around Chandigarh, north India, during June, July and August 1981. Considering the difficulty of virus isolation, the indirect immunofluorescence test was used for the demonstration of virus-specific antigen in the cytoplasm of exfoliated conjunctival cells, using reference antisera. The epidemic appeared to be primarily due to enterovirus type 70. The method was found suitable for the rapid diagnosis of AHC cases and for detecting subclinical infection among healthy subjects and convalescent carriers. During follow-up, it was observed that some of the AHC cases were shedding virus-infected conjunctival cells for a prolonged period, even after clinical recovery and during convalescence, before they became free from virus. In the absence of virus isolation, this method can be considered as suitable for the epidemiological monitoring of AHC.

Acute Disease↗

Long-term T-cell lines from the tears of patients with vernal conjunctivitis.

Previous studies of the tears and conjunctival tissue of vernal conjunctivitis (VC) have suggested that cellular immune mechanisms may be important in the inflammatory process of this ocular disease. However, little information is available in support of a cell-mediated immune mechanism because of the difficulty of tissue access and the small numbers of mononuclear cells in the tear secretions. Tear secretions of VC patients contain few lymphocytes (estimated 10(3) per 300 microliters of tears). Tear lymphocytes from 5 of 7 VC patients were propagated in culture in the presence of interleukin 2. In 2 months of culture the tear lymphocytes were expanded to 5 x 10(6)-10(7) cells. Phenotyping studies with monoclonal antibodies showed that all cell lines exhibited T-cell markers. In 2 of 3 tear specimens which were initially cultured in the presence of the putative specific antigen, i.e. rye grass or ragweed antigen E, the OKT4 helper/inducer phenotype predominated while the cell lines without antigen exhibited mostly the OKT8 phenotypes. These studies demonstrated the feasibility of generating long-term IL-2 dependent T-cell lines from the tear secretions of patients with VC which will enable the study of localized cellular immune processes in external ocular disease.

Antibodies, Monoclonal↗

Oxymetazoline ophthalmic solution versus naphazoline solution in non-infectious conjunctivitis.

A double-blind, randomized study was carried out in 38 adult patients with non-infectious conjunctivitis to compare the efficacy and tolerance of oxymetazoline (0.025%) ophthalmic solution with that of naphazoline (0.04%) solution. Treatment was continued for 7 to 8 days and severity of symptoms was recorded before, during and at the end of therapy. At the end of the study period, 11 (69%) of 16 patients treated with oxymetazoline demonstrated a good to excellent response to therapy compared with 8 (53%) of 15 patients in the naphazoline-treated group. A statistically significant difference favouring oxymetazoline was observed in duration of action and the mean number of applications needed. No adverse reactions were reported in either treatment group.

Adult↗

Giant papillary conjunctivitis following cataract extraction.

Out of a series of 600 cataract extractions, 14 patients were found to have giant papillary conjunctivitis (GPC) due to 10-0 nylon sutures. When renewed conjunctival irritation appears weeks or months after surgery, GPC should be suspected and confirmed by eversion of the upper eyelid at the slit lamp. Free edges of protruding corneoscleral nylon sutures should be looked for. Signs and symptoms of GPC disappear within one to four weeks after removal of the offending suture.

Aged↗

Enterovirus 70 acute hemorrhagic conjunctivitis--sporadic cases.

Acute hemorrhagic conjunctivitis (AHC) has been reported in epidemics. This is a report of 29 sporadic cases of AHC recorded over a period of two years after the 1981 epidemic in and around Chandigarh. A rapid and simple immunofluorescence test was developed and standardized in our Institute for the diagnosis of AHC. It was used for epidemiological monitoring of cases and to establish the diagnosis in suspected cases of AHC reporting after the epidemic. The clinical picture of epidemic and sporadic cases is compared.

Acute Disease↗

Staphylococcal infection superimposed on guinea pig inclusion conjunctivitis.

We have studied the effect of superimposed staphylococcal infection on guinea pigs who had inclusion conjunctivitis. Although the acute phase of the inclusion disease was slightly more intense in the superinfected group, the course and duration were unaltered. We did not find any reactivation of the inclusion disease from the subconjunctival injection of glucocorticoid.

Acute Disease↗

Treatment of seasonal conjunctivitis: comparison of 2% and 4% sodium cromoglycate ophthalmic solutions.

In a double-blind, noncrossover, group study a 2% ophthalmic solution of sodium cromoglycate (Opticrom) was compared with a 4% solution in the treatment of ragweed-pollen-induced conjunctivitis. The 22 female and 18 male patients, ranging in age from 10 to 61 years, had a history of troublesome eye symptoms during the ragweed season for at least 2 years and had previously obtained minimal relief with the 2% solution. They were randomly assigned to two treatment groups in matched pairs and instructed to use one drop of the medication in each eye four times a day for 4 weeks. Treatment efficacy was evaluated from the patients' daily diaries, periodic clinical assessments and subjective reports by the patients at the end of the trial. Analysis of the symptom severity scores and evaluations by both the patients and the clinician indicated that the 4% solution was more effective than the 2% solution in controlling the symptoms. No local or systemic side effects were encountered.

Adolescent↗

Conjunctival synthetic fiber granuloma. A lesion that resembles conjunctivitis nodosa.

Histopathologic examination of forniceal conjunctival lesions excised from five young patients revealed granulomatous inflammation surrounding filamentous foreign material. Polarization microscopy, special histochemical stains, scanning electron microscopy and energy dispersive x-ray elemental analysis identified the inciting material as predominantly synthetic fabric fiber. Three of these cases initially were diagnosed as conjunctivitis nodosa, an inflammatory reaction to caterpillar setae. Many synthetic fibers contained numerous granules of titanium, barium, or zinc delustering agent, which served to differentiate them from natural fibers or caterpillar hairs. Synthetic fabric fiber is a previously unrecognized cause of conjunctival inflammatory mass lesions.

Adolescent↗

Acute haemorrhagic conjunctivitis in Soweto, 1982. An epidemiological investigation.

In mid-March 1982 an epidemic of acute haemorrhagic conjunctivitis (AHC) broke out in Soweto. Over 34 000 people were treated before the epidemic subsided some 13 weeks later, the overall attack rate being 34,1/1 000. The records of 3 945 patients seen at St John's Eye Hospital were analysed, and the populations at greatest risk of contracting the disease were identified. Males were at greatest risk, with a male to female attack rate ratio of 1,8:1. The age-specific attack rates for both sexes show a similar pattern, peaking in the young adult age groups.

Acute Disease↗

A double-blind clinical trial wtih cromoglycate eye drops in patients with atopic conjunctivitis.

In a group of 33 typical hay fever patients with apparent conjunctivitis a double-blind clinical trial was carried out during the summer of 1978. One group of patients used 2% cromoglycate eye drops and the other group used placebo eye drops, both in sterile unit-dose packages without benzalconium hydrochloride. Symptoms and use of other symptomatic treatment were recorded daily. The mean daily scores were compared with the daily pollen counts. The daily records of symptoms were somewhat lower in the cromoglycate than in the placebo group, though not significantly so. Mean daily scores of symptoms correlated with the pollen counts fairly well. Need of symptomatic medication did not differ in either groups and had no relation to the pollen counts. Although a beneficial effect had been expected, cromoglycate eye drops were considered ineffective in this study.

Administration, Topical↗

[Sodium cromoglycate eyewash in allergic conjunctivitis. Multicentric controlled double-blind study. Review of the literature].

A randomized double-blind trial was conducted in 143 out-patients with allergic conjunctivitis (281 eyes). Active sodium cromoglycate collyre was compared with placebo in parallel groups over a four-week period. Highly significant advantage for active drug was demonstrated for subjective and objective symptoms as well as for overall assessment by patients and physicians. Results were compared with international data concerning this well-known anti-allergic compound.

Adult↗

Serum and tear antibodies to Chlamydia after reinfection with guinea pig inclusion conjunctivitis agent.

Repeated inoculation of th eyes of guinea pigs with the naturally occurring Chlamydia psittaci agent, guinea pig inclusion conjunctivitis (GPIC), showed that animals gradually become susceptible to reinfection with the passage of time after primary infection. Higher levels of serum IgG antibody had a significant association with resistance to challenge inoculation only with a high dose (250 ELD50) but not with a low dose (25 ELD50) inoculum. With each inoculum, however, some animals with high serum antibody were susceptible. the presence of antibodies in tears did not correlate with resistance to the first low-dose challenge inoculation, but both tear IgG and secretory antibody did have a significant association with resistance on the second rechallenge with a high-dose inoculum. Topical treatment of the eye with immune serum or tears during primary infection reduced the amount of agent in the conjunctiva only during the period of application. Local treatment of the eye with heat-killed vaccine prior to primary infection did not produce detectable antibody or protect animals against challenge inoculation; this local immunization did "prime" the animals, however, so that they had an accelerated antibody response after infection. Although there is abundant evidence that local immunity has an important role in resistance to challenge inoculation with GPIC, serum and tear antibody levels correlate equally well with resistance to repeated ocular challenge inoculation. Effective immunization procedures for this chlamydial infection then would involve stimulation of both local and systemic immune responses.

Animals↗

Acute haemorrhagic conjunctivitis.

An extensive outbreak of acute haemorrhagic conjunctivitis is being experienced in South Africa. This is part of a pandemic affecting Africa, Asia and the Americas. It is thought to be caused by enterovirus 70 and is highly contagious, the main mode of transmission being direct contact. The disease is usually confined to the eye and is self-limiting, requiring only symptomatic treatment. Sequelae have been reported, most concern being caused by the neurological complications.

Acute Disease↗

Ocular and dermal delayed hypersensitivity reactions in guinea-pigs following infection with guinea-pig inclusion conjunctivitis agent (Chlamydia psittaci).

Guinea-pigs which had been sensitized to guinea-pig inclusion conjunctivitis agent by ocular infection, were given ocular and dermal challenges with a range of doses of agent. Ocular delayed-type hypersensitivity responses were elicited by a wide range of doses. Such responses were associated with the presence of chlamydial inclusions and inflammatory cells. The EID50 for ocular reinfection was only slightly higher than that for primary ocular infection. Dermal delayed-type hypersensitivity reactions were produced only when high doses of agent were used. The relevance of these observations to human chlamydial eye disease is discussed.

Animals↗

Behaviour on the nasal provocation test in patients affected by conjunctivitis and/or asthma of allergic origin.

In the Allergo-Immunological Centre of Rome University we selected 120 patients of both sexes, ranging from 5-65 years of age, affected by asthma and/or conjunctivitis without past or present history of nasal impairment (itching, sneezing, hydrorrhea). As a result of the allergometric tests carried out, the authors divided the samples into three groups: 1) positive reaction to Dermatophagoides Pteronissimus (66.6%); 2) positive reaction to the Graminacee (28.3%); 3) positive reaction to Parietaria officinalis (5.1%). After having undergone the rhinoreomanometric test of nasal provocation, 50% of the patients revealed a positive reaction to the specific allergen, more specifically at 50 PNU/ml 40% of the case were positive, and at 100 PNU/ml 50% were positive. These results are discussed in the light of modern biological knowledge on the mastocytes in normal subjects and in those suffering from allergy.

Adolescent↗