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Results for “CORNEAL ULCER”

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At least 19 recordsLinked to original sources
PubMed2002

Mechanisms of corneal ulceration.

Corneal ulceration is a significant cause of visual morbidity. Although this discussion has primarily focused on the local factors involved in non-immune related sterile corneal ulcerations, an understanding of these mechanisms is important since a final common pathway that is conceivably relevant to all forms of corneal ulceration exists. With respect to the treatment of chronic sterile ulcerations, our contemporary armamentarium is extensive; an acknowledgement to the inadequacies of any single strategy. A sound appreciation of the subtleties involved in the pathogenesis of corneal ulceration and the orchestration of wound repair will lead us towards more effective strategies to decrease inflammation associated with ulceration, promote corneal wound healing, and ultimately provide better care for our patients.

Cornea↗
PubMed2002

Entropion, corneal ulcer and corneal haemorrhages in a one-humped camel (Camelus dromedarius).

An unusual case of entropion, corneal ulcer and corneal haemorrhages in a one-humped camel (Camelus dromedaries) is described. The most prominent clinical findings were entropion of both eyelids, severe blephrospasm, epiphora, conjunctivitis, conjunctival oedema, mucopurulent conjunctival discharges, hyperaemia, lacrimation and photophobia. Corneal ulcers and corneal haemorrhages were also observed.

Animals↗
PubMed1981

Corneal ulcers in corneal transplants.

Twenty-nine eyes, representing an infection rate of 4.9%, developed corneal ulcers following corneal transplant surgery; 26 with available data are presented. All occurred in the graft or at the wound margin. The median postoperative time to ulcer development was 5.5 months. All eyes were on topical steroids when the ulcer developed. Other associated factors were: loose sutures, bandage lenses and eyes grafted for herpes simplex keratitis. Ninety percent of the ulcers had one or more of these factors. Positive cultures for organisms were obtained in 75% and positive gram stain in 68% of the ulcers. Nine genera of bacteria were cultured; S. epidermidis, S. pneumoniae, P. aeruginosa and Corynebacterium were the most common organisms. Ninety-five percent of the bacteria tested were sensitive to gentamicin. Visual reduction occurred in 46% of the cases overall; herpetic corneas had an 88% incidence of visual loss.

Bacterial Infections↗
PubMed1976

Therapeutic effects of heparin on Pseudomonas-induced corneal ulceration.

Fifty organisms of Pseudomonas aeruginosa were injected intralamellarly in both eyes of 60 albino rabbits. Twenty-four hours later, all eyes were graded and stratified into six groups of ten rabbits with equivalent infections. Treatment was begun with gentamicin alone or 0.3% polymyxin B alone, and in combination with acetylcysteine, 0.3M edetate disodium, and 2.500 units/ml of heparin sodium, four times daily. We also compared topical colistin and colistin and topical heparin. After two weeks, those corneas treated with polymyxin B and topical heparin showed a reduction in ulceration, corneal thinning, and descemetocele formation compared to those treated with polymyxin B alone. Based on these studies, heparin was administered topically, four times daily, to three patients with Pseudomonas-induced corneal ulcers in addition to antibiotics. Before treatment all corneas showed evidence of corneal liquefaction and two of the corneas were in imminent danger of perforation. After therapy, no corneas perforated; one patient recovered visual acuity of 6/9 (20/30), one patient recovered visual acuity of 6/6 (20/20) after keratoplasty, and the third has a vascularized leukoma.

Acetylcysteine↗
PubMedDate not supplied

Management of noninfectious corneal ulcers.

Noninfectious corneal ulcers can occur as an isolated ocular problem (e.g., sequela of eye injury, Mooren's ulcer) or they may be associated with various collagen vascular or other autoimmune diseases, sometimes being the presenting sign of the disease. Conditions that affect the integrity of the ocular surface epithelium (exposure keratitis, neurotrophic keratitis, keratomalacia, recurrent corneal erosions) may also lead to development of sterile corneal ulcers. Rarely, these ulcers occur as a complication following cataract surgery. With recent advances in the understanding of the causes and pathophysiology of corneal melting, rapid and effective medical and surgical treatment is often able to halt relentless destruction of the cornea. Since treatment varies vastly depending on the underlying cause of the ulceration, prompt and accurate diagnosis is of critical importance. This review presents guidelines for the diagnosis of corneal ulcers, and a stepwise approach to their medical and surgical treatment.

Burns, Chemical↗
PubMed1979

Clostridium perfringens corneal ulcer.

A corneal ulcer caused by Clostridium perfringens developed in a 76-year-old woman with Sjögren's syndrome. Experimental C perfringens keratitis was induced in rabbits by the intrastromal injection of 10(7) organisms. In both our patient and the experimental animals, a bullous lesion overlay the affected area of the cornea. This may be a specific lesion in clostridial infections of the cornea. Clostridium perfringens should be regarded as an opportunistic corneal pathogen, and anaerobic cultures should be performed in all cases of suspected bacterial corneal ulcer.

Aged↗
PubMed2006

[Diseases of the adnexa in the tropics: amnion membrane transplantation for noninfectious trachoma-associated corneal ulcers].

BACKGROUND: Corneal ulcers with fornix shortening associated with late stages of cicatrizing trachoma contribute significantly to blindness in many developing countries. We report on the outcome of ocular surface and fornix reconstruction using amnion membrane transplantation. PATIENTS AND METHODS: From 2001 to 2005, cryopreserved human amnion membrane without mitomycin C was grafted to 25 eyes of 17 patients with trophic corneal ulcers and symblepharon (cicatrizing trachoma: 19 eyes of 14 patients, Stevens-Johnson syndrome: 4 eyes of 2 patients, alkali burns: 2 eyes of 1 patient) in a controlled case series. Follow-up was done up to 6 months. STATISTICS: Fischer's exact probability test. RESULTS: Of 25 eyes, 9 of 19 eyes with trachoma, 3 of 4 eyes with Stevens-Johnson syndrome, and 2 of 2 eyes with chemical burns showed complete reepithelialization and stromal recovery after 28-35 days (mean: 31+/-2.3 days). The primary success rate of trachoma eyes was not significantly different from the other indications (p=0.256). At 6 months post-op, 15 of 19 trachoma eyes (79%) compared to 2 of 6 non-trachoma eyes (33.3%) had developed a recurrence of symblephara (p=0.0592), and 13 of 15 eyes (86.6%) with a cicatricial trachoma compared to 1 of 6 with non-trachoma diagnosis experienced a recurrence of corneal vascularization (difference nonsignificant: p=0.1752). Persistent long-term reepithelialization was observed only in 1 of 19 trachoma eyes (5.3%) versus 4 of 6 non-trachoma eyes (66.7%, p=0.005); 3 of 19 trachoma eyes with a recurrence of ulcers had perforated after 6 months. CONCLUSIONS: Human amnion membrane without mitomycin C can be used for ocular surface reconstruction in selected patients with cicatrizing trachoma. Its efficacy in the long-term rehabilitation of cicatrizing trachoma seems to be limited due to the progressive scarring.

Adult↗
PubMed1990

[The efficiency of treating ulcerative corneal lesions with fibro nectin].

The paper analyses results after experimental studies of effectiveness of medical forms of fibronectin used in a form of eye drops for treatment of infectious keratitis on a model of bacterial corneal ulcer in 30 rabbits (60 eyes). The results obtained speak about a pronounced stimulating action of fibronectin on reparative processes: almost a twice quicker epithelialization of corneal defects (by 46.8%) and a quicker reverse development of inflammatory signs as compared with the control group of animals. Results of experimental studies allow to recommend fibronectin for treatment of patients with infectious keratitis, bacterial ulcers of the cornea.

Animals↗
PubMed2003

Diagnosis and management of chronic corneal epithelial defects (indolent corneal ulcerations).

Chronic corneal epithelial defects (CCEDs; indolent corneal ulcerations) are the most common refractory ulcerations in veterinary medicine and are diagnosed by their classic appearance. CCEDs are superficial ulcerations without stromal involvement and have a nonadherent epithelial border (lip). Fluorescein stain adheres to the exposed stroma and extends below the epithelial border, outlining the epithelial lip. CCEDs occur secondary to adnexal disease, keratoconjunctivitis sicca, exposure keratitis, neurotrophic keratitis, and primary corneal disease. In cats, herpes keratitis is associated with the development of CCEDs. Bacterial infections are not responsible for the refractory nature of CCEDs. Because of the refractory nature of CCEDs, treatment can be frustrating for both owner and veterinarian. Current treatment recommendations consist of identifying and treating the underlying cause and performing procedures that stimulate epithelialization and adhesion of the corneal epithelium. Initial treatment of CCEDs includes ulcer debridement and grid keratotomy. Superficial keratectomy is indicated in refractory cases.

Animals↗
PubMed2005

Corneal ulcers in two children wearing paragon corneal refractive therapy lenses.

OBJECTIVES: To report the development of corneal ulcers in two children wearing Paragon Corneal Refractive Therapy (CRT) lenses. METHODS: Two case reports of children who developed corneal ulcers when fit with Paragon CRT contact lenses, which were worn nightly, are discussed. Each patient presented with a bacterial corneal ulcer after wearing CRT contact lenses for less than 6 months. In the first patient, Pseudomonas aeruginosa was identified as the causative organism. In the second patient, Haemophilus influenza was cultured from the ulcer. RESULTS: Both patients were treated with intensive, fortified antibiotics with rapid resolution of the corneal ulcers and preservation of vision. No surgical intervention was required. CONCLUSIONS: Paragon CRT lenses have been approved for use in patients of all ages. When used in children, these lenses may present unique problems. The absolute incidence of bacterial corneal ulcers in patients with CRT lenses are unknown. Severe caution should be used before prescribing CRT lenses for children and informed consent should include potential sight-threatening corneal ulcers.

Child↗
PubMed2006

Penetrating keratoplasty for perforated corneal ulcers: preservation of iris by corneal debulking.

PURPOSE: This study was designed to study an alternative technique of lamellar separation of corneal layers for therapeutic keratoplasty in place of an en bloc removal of host corneal button in eyes with perforated corneal ulcers with pseudocornea. METHODS: Twelve eyes with perforated corneal ulcers with pseudocornea in which therapeutic keratoplasty was planned were included in the study. A new technique was used in which the host corneal tissue was removed in layers by lamellar dissection started peripherally and proceeding centripetally with care taken to prevent perforation at the site of iris incarceration. After injection of viscoelastic into the anterior chamber with a 26-gauge needle entered tangentially, the deeper layer of the cornea was then gently dissected and peeled away from the iris tissue, with care not to avulse the fragile iris and the overlying fibrotic membrane. Adjunctive procedures were performed, and the donor tissue was secured over the host bed. RESULTS: A complete separation of the iris tissue from corneal button and the fibrous membrane was achieved in 9 eyes. In 3 eyes, iris was partly trimmed along with the fibrous membrane, because the membrane was totally adherent to the iris tissue. Eight patients required pupilloplasty. Apart from minimal bleeding, no other complication was encountered. At the end of 3 months, 9 of 12 grafts remained clear. CONCLUSIONS: Debulking and layer-by-layer removal of host corneal tissue is effective in preservation of iris while performing therapeutic keratoplasty in eyes with perforated corneal ulcers with pseudocornea.

Adult↗
PubMedDate not supplied

An emergency corneal ulcer kit.

Bacterial corneal ulcer is a potentially blinding emergency which should ideally be treated by an ophthalmologist aided by slit lamp biomicroscopy, microbial stain and cultures, and then selected fortified topical antibiotics. We suggest an emergency corneal ulcer kit for the initial treatment of patients with suspected corneal ulcers who are unable to readily travel to an ophthalmologist.

Aminoglycosides↗
PubMed1991

Epidemiologic characteristics, predisposing factors, and etiologic diagnosis of corneal ulceration in Nepal.

Corneal ulceration is one of the most frequent causes of blindness in developing countries. Between September 1985 and August 1987, 405 patients with corneal ulceration were examined at Tribhuvan University Teaching Hospital in Kathmandu, Nepal. Males and females were equally affected. The most common predisposing cause of ulceration was corneal trauma, usually with organic agricultural materials. Microorganisms were grown from 324 (80%) of the ulcers. Pure bacterial cultures were obtained from 256 (63.2%) of the patients, whereas pure fungal cultures were obtained from 27 (6.7%) of the patients. In 41 patients (10.1%), corneal cultures yielded a mixed growth of bacteria and fungi. Of a total of 398 bacterial isolates, 124 (31.1%) were positive for Streptococcus pneumoniae, the most commonly isolated organism in the series. Other frequently isolated bacteria included Staphylococcus epidermidis, S. aureus, and Pseudomonas species. Of 68 positive fungal isolates obtained, 32 (47.0%) were identified as Aspergillus species. Candida species and Fusarium species were less commonly seen.

Adolescent↗
PubMed1997

Trial of chlorhexidine gluconate for fungal corneal ulcers.

AIMS: Suppurative corneal ulcers due to filamentous fungi are a serious and intractable problem in many tropical developing countries. In vitro studies and a small pilot study have shown that chlorhexidine gluconate is effective. The aim was to establish the optimum concentration which would be appropriate to use in a larger randomized clinical trial. METHODS: A masked randomized clinical trial of three concentrations of chlorhexidine compared with natamycin 5% was carried out in consecutive patients with established corneal ulcers shown by microscopy to contain fungal hyphae and later proven to be culture positive. Topical treatments were applied 1/2-hourly to 2-hourly for up to 5 days, with reduced frequency thereafter, and all patients were re-assessed at 21 days. RESULTS: Of 60 patients entered in the trial, 2 were lost to follow-up, and 12 were classified as 'severe' with little prospect of recovery. At 5 days the response was related to the concentration of chlorhexidine, with 0.2% giving the best results. Compared with the response to natamycin as the referent, the relative efficacy was 1.17 with chlorhexidine 0.05%, 1.43 with 0.1%, and 2.00 with 0.2%. The superiority of 0.2% chlorhexidine over natamycin was statistically significant (relative efficacy 2.20, p = 0.043) in patients not having had prior antifungal treatment. CONCLUSIONS: This preliminary study justifies further trials of chlorhexidine as a primary treatment for fungal corneal ulcers in circumstances where specific antifungal agents are not available.

Administration, Topical↗