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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In reviewing the clinical features, diagnostic evaluations and therapies of the most common ocular viral infections we attempt to whet your appetite for attacking the numerous challenges in diagnosis and treatment of viral eye disease. The herpes viruses, HSV, VZV and CMV are the cause of significant ocular morbidity. HSV most commonly affects the cornea producing keratitis that can be recurrent and may lead to corneal clouding and neovascularisation. Manifestations can be purely infectious or immunological and treatment options must be tailored to the underlying pathophysiology. Herpes zoster ophthalmicus, caused by VZV infection of the first branch of the trigeminal nerve, produces a characteristic rash and can progress to keratitis and uveitis. HSV and VZV can cause retinitis in both immunocompetent and immunocompromised individuals. There has been a significant increase in the incidence of CMV retinitis since the beginning of the AIDS epidemic. We review the numerous new treatments, diagnostic tests and treatment strategies which have been developed in response to this potentially blinding retinal infection. Adenovirus produces an epidemic conjunctivitis and epidemic keratoconjunctivitis which are severe and extremely contagious conjunctival infections. HIV, molluscum contagiosum, EBV and rubeola also cause ocular diseases which are described.Copyright 1998 John Wiley & Sons, Ltd.
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PMID:Virus infections of the eye. 1039 8

Ocular virus infections remain an important cause of corneal and external disease. Herpes simplex, the most important, is easily treated when it is confined to the epithelium. New studies indicate that herpetic stromal disease and iritis are effectively treated with a combination of corticosteroid and antiviral without additional risk. Recurrences of ocular herpetic disease can be reduced with acyclovir given orally; the benefit seems to be greatest in patients who have had at least one episode of stromal keratitis. Herpes zoster can be treated with either acyclovir or famciclovir, but to be effective, treatment must be initiated within 72 hours of onset. Early treatment reduces the risk of post-herpetic neuralgia and may reduce the risk of ocular complications. Adenovirus infection (epidemic keratoconjunctivitis) is often spread by the ophthalmologist. New medications such as cidofovir appear to be effective against the adenoviruses in non-human systems and may have some effect in man, although previously, drugs that appeared to have an effect in vitro have proven to be ineffective in the clinical setting.
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PMID:Treatment of viral diseases of the cornea and external eye. 1061 81

Six cases of infectious keratoconjunctivitis (IKC) in mule deer (Odocoileus hemionus) and moose (Alces alces) in Wyoming (USA) were investigated during fall and winter of 1995 and 1996. Excessive lacrimation, mucopurulent conjunctivitis, keratitis, and corneal opacity were observed in mule deer. Moose had severe mucopurulent conjunctivitis, keratitis, and corneal ulceration. Hemolytic, non-piliated Moraxella ovis was isolated from two mule deer and two moose. We attempted to reproduce IKC in three mule deer fawns using an isolate of M. ovis from a clinically affected mule deer. These fawns did not develop clinical signs of infection and the bacterium was not reisolated from inoculated deer. Inoculated deer may not have developed clinical signs because deer were not exposed to ultraviolet light or mechanical insult before inoculation. In addition, the isolate used for inoculation may have lost virulence factors through passage, or M. ovis may not have been the primary pathogen responsible for clinical disease in the natural cases of IKC we investigated. The etiology of IKC in free-ranging wild ruminants remains poorly understood.
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PMID:Association of Moraxella ovis with keratoconjunctivitis in mule deer and moose in Wyoming. 1081 5

We report the isolation of Ewingella americana from the conjunctivae of a 38 year old female physician with keratoconjunctivitis associated with the use of soft contact lens. The patient was treated successfully with topical ciprofloxacin. The source of the infection remains unknown. All contact lens cleaning materials used by the patient were sterile. Since the patient was a physician, and this organism has been recorded as a cause of nosocomial infections, we checked whether cases of Ewingella americana had been reported, but none were identified. We have identified 39 bacterial species, 27 fungi, 4 viruses, 7 protozoa, 4 helminths, and 2 arthropods which rarely have been associated with keratitis or conjunctivitis. Infectious diseases specialists and ophthalmologists must be aware of the many different causes of this illness, including Ewingella americana. This organism is a rare bacterial cause of keratoconjunctivitis not previously reported in Brazil. It should be added to the list of unusual cases of external eye infections.
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PMID:A case of keratoconjunctivitis due to Ewingella americana and a review of unusual organisms causing external eye infections. 1106 58

Ophthalmic allergoses belong to highly prevalent ocular diseases. According to the records of the first center of allergic diseases of the eye set up in 1971 at Helmholtz Institute of Ocular Diseases in Moscow, the most prevalent clinical forms are seasonal pollenosis conjunctivitis, drug allergies, spring keratoconjunctivitis, large-papillary conjunctivitis, chronic allergic conjunctivitis, allergy associated with the "dry eye" syndrome, atopic keratoconjunctivitis, and ocular involvement in systemic immune diseases. Therapy of ocular allergies is based on the three main principles: removal of the allergen responsible for disease, immunotherapy, and symptomatic drug therapy. The main agents used in local antiallergic therapy are antihistaminic drugs (antasoline and acelastin), drugs inhibiting mast cell degranulation (chromoglycates and lodoxamide), and accessory drugs: corticosteroids (dexamethasone and deosonide), nonsteroid antiinflammatory agents (diclofenak), immunosuppressants (cyclosporin), and vasoconstrictors (tetrisoline). Antiallergic drugs can be used as monotherapy or in combinations, as they differ by the mechanism of action. Antiallergic drugs are used with good results in combined therapy of infectious conjunctivitis and keratitis.
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PMID:[New aspects in drug therapy of ocular allergies]. 1122 68

An 8-month-old 3-kg (6.6-lb) sexually intact male cat was evaluated for chronic refractory keratitis and a corneal plaque that developed after treatment with a corticosteroid-containing ophthalmic preparation. Pertinent ophthalmic findings included blepharospasm, conjunctivitis, corneal vascularization, and a tan raised corneal plaque with a dense and gritty composition. Lamellar keratectomy was performed to excise the plaque. The cornea healed with mild scarring. Histologic examination revealed extensive coagulation necrosis and mineralization of the corneal stroma with increased inflammatory cells, blood vessels, and fibrosis, which is compatible with a diagnosis of mineralized corneal sequestrum. The history suggested chronic feline herpesvirus-1 (FHV-1)-induced keratoconjunctivitis as the underlying cause. Topical corticosteroid administration may have potentiated the preexisting corneal necrosis and initiated mineralization. To our knowledge, mineralization of a corneal sequestrum in a cat has not been reported in a clinical case but has been reported in cats experimentally infected with FHV-1.
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PMID:Mineralized corneal sequestrum in a cat. 1175 95

We report 3 patients who experienced a recurrence of nonherpetic keratitis after excimer laser photorefractive surgery. Two patients had a history of culture-positive adenoviral keratoconjunctivitis, and 1 had a clinical diagnosis of Thygeson's superficial punctate keratitis (SPK) prior to excimer laser surgery. Patients should be informed that excimer laser surgery may contribute to a recurrence of keratitis and Thygeson's SPK. Recognition and appropriate treatment can result in resolution and maintenance of a good refractive outcome.
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PMID:Recurrence of keratitis after excimer laser keratectomy. 1255 88

In the retrospective study the authors evaluate clinical results of phototherapeutic keratectomy (PTK) that is one of the alternative methods used in treatment of some of the superficial corneal diseases. The authors present the group of 89 eyes of 63 patients with diagnose: dry spot corneae in 69 eyes (77.5%), recurrent corneal erosion in 13 eyes (14.5%), corneal dystrophy in 2 eyes (1.8%), recurrent herpes simplex keratitis in 3 eyes (2.7%), recurrent pterygium in 2 eyes (1.8%), atopic keratoconjunctivitis with mucous plaque in 1 eye (0.9%). The average age was 45.2 years (14-84 years) and average follow-up period was 29 months (3-52 months). The operation was done with the use of device Keracor 117 (ArF excimer laser) in topical anaesthesia, with the average zone of ablation 4.1 mm and average depth of ablation 24 mu in one go. In ten cases was the operation carried out repeatedly. We evaluated the postoperative complications, postoperative changes of refraction and final the best corrected visual acuity. For low percentage of postoperative complications, decrease or disappearance of subjective difficulties and improvement of visual acuity with minimal stress for the patient we can recommend PTK as save and efficient method in treatment of corneal diseases mentioned above.
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PMID:[Phototherapeutic keratectomy in the treatment of superficial corneal diseases]. 1282 1

A 47-year-old woman with a history of laser in situ keratomileusis (LASIK) 2 years previously for myopia and astigmatism, presented with bilateral loss of vision due to diffuse lamellar keratitis (DLK) with corneal edema in the context of a pseudomembranous viral keratoconjunctivitis. After intense and early treatment with topical corticosteroids, the corneal edema and DLK resolved and corneal transparency was achieved with complete restoration of visual acuity. This case shows that DLK may occur associated with a viral pseudomembranous keratoconjunctivitis in patients who have had LASIK. Diffuse lamellar keratitis may present up to 2 years after lamellar surgery, which would indicate that the plane created by the microkeratome at the interface may remain unhealed for at least this period of time. Early diagnosis and treatment with topical corticosteroids can achieve complete resolution without visual loss.
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PMID:Diffuse lamellar keratitis and corneal edema associated with viral keratoconjunctivitis 2 years after laser in situ keratomileusis. 1517 19

The aim of this study was to investigate the presence of Herpes simplex virus type 1, in the specimens from patients clinically prediagnosed as herpetic keratitis or keratoconjunctivitis, by virus isolation and direct immunoperoxidase methods. The samples obtained from a total of 33 patients included ulcerated corneal epithelium scrapings and, swabs from ulcer, corneal epithelium, and lower conjunctivas. For virus isolation, both scraping and swab samples for each patient, were inoculated into monolayered Vero cell lines which have previously cultivated on 24-well plates, and examined for the presence of cytopathic effects typical for HSV-1. At the end of 5-days incubation period, the culture media were discarded, the cells were fixed and stained with peroxidase labeled specific HSV-1 antibodies (direct immunoperoxidase--DIP--method). Simultaneously, the smears were prepared from the samples which were sufficient in amount, and stained with DIP method. As a result, cytopathic effects on cell cultures were observed in 4 (12.1%) of the samples, of which 2 were also positive with DIP method. Following DIP staining of smears prepared from 15 samples, HSV-1 antigen positivity was detected in only 1 of the samples. This sample was negative in cell culture. In contrast, one of the 2 cell culture positive samples yielded negative result in smear examination, while the other could not be examined since the sample was not enough. In conclusion, HSV-1 has been shown as the etiologic agent in 3 (9.1%) of our patients clinically prediagnosed as herpetic keratitis or keratoconjunctivitis, and lesion scrapings were determined as the most appropriate samples for virus isolation.
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PMID:[Herpes simplex virus type 1 in the samples of patients with clinically prediagnosed as herpetic keratitis or keratoconjunctivitis]. 1529 2


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