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At least 19 recordsLinked to original sources
PubMed2001

Pharmacotherapy of fungal eye infections.

Fungal eye infections are rare. Trauma associated with contamination by vegetative material, contact lens wear and long term corticosteroid use are common risk factors. The aims of treatment are to preserve visual function, which depends on the rapid diagnosis and efficient administration of appropriate antifungal therapy. This necessitates a clinical suspicion of fungal aetiology and the taking of appropriate smears and cultures as early as possible to identify the fungal organism. Currently there are three main classes of drugs available for use in fungal eye infections: polyenes, azoles as derivatives of imidazoles, and 5-fluorocytosine. Of the polyenes, amphotericin B, natamycin and nystatin are of clinical ophthalmic use. Based on better pharmacokinetic profiles and spectra of antifungal activity, the triazoles are the agents of choice. Successful treatment of fungal keratitis depends on early initiation of specific therapy consisting of topically-applied antifungal agents since topical administration is most likely to provide the best opportunity for achieving therapeutic corneal levels. Hence, the molecular weight of the various antifungal agents is of importance since it influences their ability to penetrate the corneal epithelium. Systemic administration may be necessary for resistant fungal ulcers. For fungal endophthalmitis, to preserve visual function and eliminate the fungal pathogen, topical, systemic and possibly intraocular antifungal therapy is used, although some do not recommend use of systemic agents for exogenous endophthalmitis.

Anti-Inflammatory Agents↗
PubMed2005

[Penetrating keratoplasty for treatment of fungal keratitis with corneal perforation].

OBJECTIVE: To evaluate the outcome of penetrating keratoplasty (PKP) for the treatment of fungal keratitis with corneal perforation. METHODS: 40 patients (40 eyes) with corneal perforation secondary to fungal keratitis underwent PKP at Qingdao Eye Hospital from 1994 to 2003. The follow-up ranged from 6-24 months. The postoperative visual acuity and complications were documented. RESULTS: 39 (97.5%) patients preserved the eyeballs. The visual acuity improved in 38 (95.0%) eyes. Fungal infection recurred in 4 eyes, 3 of which were controlled with antifungal medication and 1 was enucleated because of the uncontrolled endophthalmitis. Graft rejection was observed in 15 (37.5%) eyes, 12 of which were cured with medication and 3 received secondary PKP. 3 (7.5%) eyes had graft ulceration, 2 of which were cured and the other one was regrafted because of severe endothelial cell loss. 5 (12.5%) eyes had secondary glaucoma, and the intraocular pressure was controlled medically and surgically. Complicated cataract occurred in 5 (12.5%) eyes, 3 of which underwent cataract extraction. Most complications were controlled successfully. At last follow-up, 36 (90.0%) grafts were clear. CONCLUSION: PKP is an effective approach for preservation of eyeballs and restoration of visual function in patients eyes with fungal keratitis and corneal perforation.

Adolescent↗
PubMed2006

[Diagnostics of fungal infections of the eye and of its adnexa].

The spectrum of fungal infections of the eye and of its adnexa is presented with respect to their clinical pictures as well as to their laboratory diagnostic monitoring. The various types of localisation are different in their symptomatologies, in their risk factors and in their aetiology.

Adult↗
PubMed2000

Fungal and parasitic infections of the eye.

The unique structure of the human eye as well as exposure of the eye directly to the environment renders it vulnerable to a number of uncommon infectious diseases caused by fungi and parasites. Host defenses directed against these microorganisms, once anatomical barriers are breached, are often insufficient to prevent loss of vision. Therefore, the timely identification and treatment of the involved microorganisms are paramount. The anatomy of the eye and its surrounding structures is presented with an emphasis upon the association of the anatomy with specific infection of fungi and parasites. For example, filamentous fungal infections of the eye are usually due to penetrating trauma by objects contaminated by vegetable matter of the cornea or globe or, by extension, of infection from adjacent paranasal sinuses. Fungal endophthalmitis and chorioretinitis, on the other hand, are usually the result of antecedent fungemia seeding the ocular tissue. Candida spp. are the most common cause of endogenous endophthalmitis, although initial infection with the dimorphic fungi may lead to infection and scarring of the chorioretina. Contact lens wear is associated with keratitis caused by yeasts, filamentous fungi, and Acanthamoebae spp. Most parasitic infections of the eye, however, arise following bloodborne carriage of the microorganism to the eye or adjacent structures.

Animals↗
PubMed1996

Review of external ocular disease associated with aids and HIV infection.

External ocular disease associated with human immunodeficiency virus (HIV) infection can often be overlooked by the eye care practitioner. Different types of external ocular disease can be an indication of the patient's overall immune status as well as the stage of HIV infection. The external ocular sequelae of HIV infection can be of visual consequence for the patient. Eye care practitioners need to become familiar with these conditions. The diagnosis and management of the following ocular conditions associated with HIV infection are reviewed: conjunctival microvascular disease, dry eye, allergic conjunctivitis, microsporidial keratoconjunctivitis, herpes zoster ophthalmicus, herpes simplex keratitis, molluscum contagiosum, fungal keratitis, bacterial keratoconjunctivitis, and Kaposi's sarcoma (KS).

AIDS-Related Opportunistic Infections↗
PubMed1997

Infectious ocular complications in orthotopic liver transplant patients.

We report the frequency and type of infectious ocular complications following orthotopic liver transplantation (OLT) and review diagnostic and therapeutic strategies. During the period September 1988 through November 1994, 684 patients underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver transplant patients (1.3%) developed ocular infections: Candida albicans endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for patients with fungal infections and 128 days for patients with viral infections. Blurred vision was the commonest symptom (five of nine cases). The mean duration of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision occurred in three patients, five had improvement in visual acuity, and one died of disseminated aspergillosis 33 days after OLT. Infectious ocular complications following OLT may occur as isolated events or with disseminated disease. Fungal infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4 months after OLT). The clinical presentation may be atypical; aggressive vitreoretinal procedures and serial examinations may be required to establish the diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may not require life-long maintenance therapy with antiviral agents.

Adult↗
PubMed1991

Tear lysozyme levels in bacterial, fungal and viral corneal ulcers.

Low levels of tear lysozyme were observed in patients with infective corneal ulcers, when compared with controls. Lowest levels were seen in patients with bacterial corneal ulcers. The levels of tear lysozyme showed a corresponding decrease with the increase in Schirmer test values; meaning thereby, that in ocular conditions associated with increased rate of tear flow, the lysozyme content in tears tends to be low.

Adult↗
PubMed2001

[Ocular parasitoses and mycoses: cases diagnosed in the Central University Hospital of Sfax between 1996 and 1999].

Parasitical and fungal ophthalmic infections are polymorphic and variably severe. They are rarely reported in publications. The aim of our study has been to specify the parasitic and fungal agents isolated from the ocular samples in our district (Sfax-Tunisia). We surveyed retrospectively the different ocular parasitosis and mycosis diagnosed in our laboratory (Sfax hospital) over a 4 year-period (1996-1999). Fungal ophthalmic infections were dominated by corneal localisations: 20 cases of keratomycosis secondary to: Fusarium solani (8 cases), Aspergillus fumigatus (3 cases); Aspergillus flavus (2 cases); Alternaria sp (2 cases), Candida albicans (2 cases); Fusarium dimerium (1 case); Fusarium oxysporum (1 case) and Scedosporium sp (1 case). A prolonged treatment by ketoconazole had a successful resolution in 70% of cases; 1 case of ciliar tinea caused by Trichophyton violaceum. Parasitic agents were dominated by Demodex folliculorum (32 cases), Phthirius inguinalis (6 cases) and Oestrus ovis (2 cases). Two cases of orbital hydatidosis and 2 cases of palpebral cutaneous leishmania were noted; 21 cases of ocular toxoplasmosis were treated by clindamycine. Our survey concerned not only cosmopolite parasitosis and fungi, but also some affections endemic to our district (hydatidosis and leishmaniasis) with manifestations in isolated ophthalmic localisation. Our research has underscored the need to specify types of infection by way of adequate sampling so as to treat early and then improve prognosis.

Adolescent↗
PubMed1999

Ocular disease in AIDS.

Explore the source record for details and available documents.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Transmission of conventional agents during outpatient care].

Outpatient care bring together in a single location a large number of patients potentially bearing conventional infectious agents (virus, bacteria, fungi, parasites). This report details the germs potentially involved. We emphasize adenovirus epidemic keratoconjunctivitis, which is particularly prevalent in ophthalmology outpatient care. We analyze the modes of contamination and the means to prevent iatrogenic infections.

Eye Infections↗
PubMed2003

Aspects of the antimicrobial mechanisms of action of a polyquaternium and an amidoamine.

OBJECTIVES: Polyquad (Alcon) (polyquaternium-1, PQ-1) and Aldox (Alcon) (myristamidopropyl dimethylamine, MAPD) are two biocides that are used commercially in a contact lens disinfecting solution, namely Opti-Free Express (Alcon) multi-purpose disinfecting solution. Their potential mechanisms of action were investigated against a range of common ocular pathogens. These were Acanthamoeba castellanii (trophozoites and cysts), Aspergillus fumigatus, Candida albicans, Pseudomonas aeruginosa, Serratia marcescens and Staphylococcus aureus. METHODS: Three aspects were investigated: the lethal effects of the biocides on the organisms, the leakage of K+ from treated cells, and the lysis of spheroplasts derived from the cells. RESULTS: PQ-1 was found to have predominantly antibacterial activity, and induced K+ leakage from the bacteria and C. albicans. It also caused lysis of spheroplasts of S. marcescens, but not those of C. albicans. MAPD was active against all of the organisms, but showed higher activity against the fungi and amoeba. It induced K+ leakage from A. fumigatus and C. albicans, and like PQ-1, lysed the spheroplasts of S. marcescens but not C. albicans. CONCLUSIONS: The two biocides have different spectra of antimicrobial activity. PQ-1 has mainly antibacterial activity, whereas MAPD was active against all of the test organisms, particularly the fungi.

Acanthamoeba↗
PubMed1989

Microbial investigations in keratitis at the Sydney Eye Hospital.

We investigated 107 cases of presumed microbial keratitis amongst patients presenting to the Sydney Eye Hospital between October 1986 and August 1988 to determine the frequency of infection, the common causative organisms and those factors that predispose to corneal infection. We found that 95% of culture-proven cases were caused by bacteria and that Staphylococcus epidermidis and Corynebacterium sp. accounted for 42.5% of these cases. All bacteria (except Staphylococcus epidermidis and Mycobacterium chelonae) were sensitive to gentamicin. In 62.6% of cases, cultures for bacteria and fungi were negative. Retrospective review of the clinical records of these patients showed that herpes simplex virus, contact lens wear, staphylococcal marginal keratitis and recurrent erosion were important causes of keratitis in this group.

Adolescent↗
PubMed1999

Aetiological study of the presumed ocular histoplasmosis syndrome in the Netherlands.

AIM: To investigate whether presumed ocular histoplasmosis syndrome in the Netherlands is caused by Histoplasma capsulatum and whether other risk factors might play a role in the pathogenesis of this syndrome. METHODS: 23 patients were clinically diagnosed as having presumed ocular histoplasmosis syndrome based on the following criteria: peripapillary atrophy, punched out lesions, a macular disciform lesion or scar in one eye without vitritis. As controls, 66 sex and age matched healthy volunteers were used. Serum samples from both patients and controls were tested for the presence of antibodies against H capsulatum, Toxoplasma gondii, Toxocara canis et cati, Ascaris sp, and for the presence of antigens of Cryptococcus neoformans. Serum samples were also tested for the presence of autoantibodies against retinal or choroidal proteins. To investigate other risk factors, patients and controls were asked to fill in a health and travel related questionnaire. Ten patients with ocular toxoplasmosis were used as a disease control group. RESULTS: None of the patients with presumed ocular histoplasmosis syndrome or controls had circulating antibodies directed against H capsulatum. No risk factors could be identified and no indications for autoimmunity and no evidence for the role of the other infectious agents could be demonstrated. CONCLUSIONS: In a Dutch group of patients fulfilling the criteria of a disease currently named presumed ocular histoplasmosis syndrome, no risk factors or relation with the fungus H capsulatum could be detected.

Adult↗
PubMedDate not supplied

Practical ophthalmic microbiology.

Infection is commonly encountered in everyday ophthalmic practice. It is of great importance that all ophthalmic personnel are familiar with the basic etiologies of these infections, and the basic techniques which are used in diagnosis. When evaluating a patient with possible infection, it is often of great help to be familiar with the normal microbial flora of the human body. This normal flora has been detailed in the article. The assumption is that knowledge of a patient's flora can help guide decisions about the possible etiologies of an infection. When presented with an obvious ocular infection, health care personnel should review the "usual suspects"--that is, the common etiologies for each type of infection. The key to combating ocular infections lies in accurate treatment of the presumed infectious agent. Therefore, the techniques and steps used in the identification of the etiology of an infection should be known to all ophthalmic personnel. The proper sterile techniques of obtaining a specimen from a suspected corneal ulcer or conjunctivitis and the plating of the specimen on specific agar for identification are essential to everyday practice (Figure 8). Patients who will undergo surgery, regardless of the type, are being placed at a special risk for infection. These post-operative infections can destroy the work of the most careful and exact surgical technique. It is an essential part of the procedure that the patient be protected as best they can from subsequent infection. The techniques to reduce the risk of post-operative infection have been detailed above. Proper preparation of a sterile field, sterile draping, and perioperative antibiotics can reduce the chance of a subsequent infection. It is important that these basic steps of care be properly provided to help insure successful surgical outcomes and excellence in health care.

Eye Infections, Bacterial↗
PubMed1999

[Infectious uveitis].

Half a century ago, bacterial diseases such as tuberculosis and syphilis were thought to cause the majority of cases of uveitis. Nowadays, a number of infectious diseases are responsible for uveitis. In our countries, herpes virus and toxoplasmosis are the principal causes of uveitis. Furthermore, because specific antimicrobial therapy can be curative and prevent long-term visual sequel, early diagnosis of infectious causes of uveitis should be a priority for all practitioners.

Adult↗
PubMed2000

The microbiology of the eye.

Infection of the external structures of the eye is one of the commonest types of eye disease worldwide. In addition, although relatively impermeable to microorganisms, infection within the eye can result from trauma, surgery or systemic disease. This article reviews the general biology of viruses, bacteria, fungi and protozoa and the major ocular infections that they cause. In addition, the effectiveness of the various antimicrobial agents in controlling ocular disease is discussed. Because of changes in the normal ocular flora, continuous monitoring of the microbiology of the eye will continue to be important in predicting future types of eye infection. Basic research is also needed into the interactions of microbes at the ocular surface. There is increasing microbial resistance to the antimicrobial agents used to treat ocular infections and hence, new antimicrobial agents will continue to be needed together with new methods of drug delivery to increase the effectiveness of existing antimicrobial agents.

Eye Infections↗
PubMed1992

[Ocular manifestations of systemic diseases in birds. Part 1].

Among the representatives of the class Aves ocular lesions may be a particularly strong indication of systemic disorders. A causative diagnosis of ocular lesions may be vital for the avian patient, not only as a basis for effective therapy of the primary disease, but also for saving the vision, as birds orientate themselves primarily by vision. The following paper presents a synopsis of important ocular disorders in avian patients that are either pathognomonic for certain disorders or, when considered in conjunction with other organic diseases, enable a specific diagnosis to be arrived at. In part 1 bacterial and parasitic etiologies will be described. Part 2 deals with viral infections and noninfectious etiologies.

Animals↗