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

Epikeratophakia continues to be an extremely attractive option for younger children with unilateral aphakia who are noncompliant users of contact lenses but who are young enough to benefit from amblyopia therapy. The epikeratophakia procedure is much safer than IOL implantation. The epikeratophakia tissue lens is especially useful for children with traumatic aphakia and corneal lacerations because the lens can strengthen and smooth the cornea as well as correct the aphakia. This allows much quicker rehabilitation than could be accomplished with contact lenses. The epikeratophakia procedure may be combined with a cataract extraction and should be in those children with acquired cataracts who demonstrate contact lens noncompliance in an office trial of contact lens insertion before operation. Epikeratophakia should be used with caution in neonates and young infants because of the rapid growth of the eye. Extended-wear contact lenses are a safer option for these children, and epikeratophakia can be performed as a secondary procedure if and when problems with contact lens compliance arise. Surface ocular problems such as uncontrolled dry eyes or severe blepharitis will continue to be incompatible with the survival of epikeratophakia tissue lenses. Children who are treated with high doses of radiation for orbital tumors such as rhabdomyosarcomas invariably develop radiation cataracts, which can occur before the onset of radiation keratitis. These children do not do well with epikeratophakia tissue lenses. Likewise, children with severe metabolic disturbances who are not healthy or gaining weight have a diminished chance of graft healing, as do children with poor vision in whom oculodigital autostimulation produces persistent epithelial defects, which prevent survival of the tissue lens.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Update on epikeratophakia in children. 264 36

Tears are absorbed by a tuft of cotton and subjected to stix test for leucocyte-esterase (L), nitrite (N), haemoglobin (H), and albumin (A). Testing of 84 cases of infectious conjunctivitis and 282 normals revealed nosographic sensitivity to L in 89% and a specificity of 98%. By including N (only 26% positive with infectious conjunctivitis) and H the sensitivity rose to 98% while the specificity fell to 95%. A was generally raised in cases of infectious conjunctivitis. An additional number of 607 stix tests were carried out on a clinical series. The reaction was controlled before, during, and after cataract extraction. Conjunctivitis patients were observed for possible infection, the result of antibiotic treatment was studied, and contact lens wearers were controlled for infection. Predominantly stix-positive reaction was noticed in keratitis, allergic conjunctivitis, and ocular prosthesis socket. Predominantly negative reaction was seen in chronic simple conjunctivitis, sicca, scleritis, and iritis, the latter despite pronounced ciliary hyperaemia. Contralateral reflexly induced L and H were rendered probable. H-positive reaction predominated immediately after removal of suture. The tear stix test is easy to carry out, reasonably precise, and valuable in the clinical work.
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PMID:Tear stix tests for leucocyte-esterase, nitrite, haemoglobin, and albumin in normals and in a clinical series. 265 63

Radial keratotomy for myopia and transverse keratotomy for astigmatism are the most commonly performed refractive surgical procedures. A decade of experience with modern techniques has produced considerable literature on the complications of keratotomy. Vision-threatening complications (bacterial keratitis, traumatic rupture of the globe through weakened keratotomy scars, endophthalmitis, cataract formation from surgical trauma to the lens) are quite rare, occurring in less than 1% of eyes in published series. The most common side effects affect most patients in the first few months after surgery: pain for 24 to 48 hours, transient glare and light sensitivity, and fluctuating visual acuity. The most common persistent complications are overcorrection and undercorrection. Persistent irregular astigmatism occurs in almost all cases in the region of the incision scars, but it is rarely severe enough to reduce spectacle acuity. Most individuals have mild glare, but this is rarely disabling. Diurnal variation of refraction in visual acuity occurs commonly, but the magnitude of the fluctuation is seldom enough to require multiple pairs of spectacles. Longterm refractive stability occurs in approximately half of eyes by six months, but approximately one in four eyes will experience continued change over six months to four years. Complications, such as scarring from intersecting keratotomy incisions, irregular astigmatism resulting from multiple reoperations, and overcorrections with the attendant early onset of symptomatic presbyopia are becoming much less frequent.
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PMID:Complications of radial and transverse keratotomy. 268 58

Graft survival in a previously reported cohort of patients recruited between 1967 and 1978 (10.6 years' mean follow-up) was reviewed and compared with that for a cohort recruited between 1979 and 1987 (3.8 years' mean follow-up). This allowed analysis of improved graft survival due to changes in management, introduced after critical review of the first group in 1978. The salient changes included transition from intracapsular to extracapsular cataract surgery (P = 0.001) and treatment of rejection episodes with antiviral prophylaxis. Extracapsular cataract surgery improved graft survival (P = 0.07) benefiting inflamed eyes which more frequently required concomitant surgery (P = 0.005). Survival of rejection episodes was improved by antiviral prophylaxis (P = 0.02), and the incidence of recurrent keratitis was reduced (P = 0.0005). The complete and prompt removal of loose sutures improved graft survival (P = 0.025). Long-term survival of first grafts was 70%, and management changes improved overall survival (P = 0.036) despite an increased number of eyes (P = 0.05) grafted when inflamed.
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PMID:The changing management and improved prognosis for corneal grafting in herpes simplex keratitis. 269 48

The ophthalmic literature of the past half century contains relatively few reports of true exfoliation of the lens capsule, reflecting a reduction in the occupation-related occurrence of "glassblower's cataract." The authors report 11 eyes (7 patients) with a diaphanous membrane arising from the anterior lens capsule, which they have identified by slit-lamp biomicroscopy. None of the seven patients had had extended exposure to an infrared-emitting heat source or ocular trauma; one patient with bilateral true exfoliation of the lens capsule had a history of unilateral herpes simplex keratitis. The average age of these patients at the time of diagnosis was 85.4 years. Identification of these 11 eyes by two ophthalmologists during a 6-year period suggests that idiopathic true exfoliation of the lens capsule has been underdetected, under-reported, or both.
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PMID:Idiopathic true exfoliation of the lens capsule. 271 May 27

The pattern of corneal disorders in Singapore is different from that seen in the western countries, and in the developing countries. Dendritic corneal ulceration, keratoconus and corneal dystrophy are relatively uncommon. Bullous Keratopathy, however, is on the increase, due mainly to the increasing number of cataract operations done and to the use of intraocular implants. Other major corneal disorders in Singapore are Exposure Keratitis and Neurotrophic Keratitis. The management of the various corneal disorders are discussed. Prevention is possible especially in those disorders due to iatrogenic factors. Constant vigilance and care are called for to prevent unnecessary surgical trauma and corneal blindness.
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PMID:Corneal blindness in Singapore and its prevention. 278 15

Ocular involvement with acute Epstein-Barr virus infection is usually limited to a transient follicular conjunctivitis, although other lesions have been reported. Chronic Epstein-Barr virus infection has recently gained attention, but ocular manifestations have not been emphasized. We describe three patients with chronic infection with prominent ocular involvement. Bilateral uveitis was noted in all patients, ranging from an anterior uveitis that was responsive to steroids to a severe panuveitis with vitritis, cataract, optic disc swelling, and macular edema. In one patient, topical acyclovir ointment resulted in a substantial decrease in the inflammatory reaction when added to systemic acyclovir therapy. Another patient displayed a keratitis that resolved with topical steroid therapy. Cataract and vitreous surgery were also beneficial in the management of these patients.
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PMID:Ocular involvement associated with chronic Epstein-Barr virus disease. 303 22

Megavoltage x-radiation was used to treat orbital nasal, and paranasal cavity malignant neoplasia in 29 dogs. In each instance, the globe and adnexal tissues were within the treatment portals (entry and/or exit). Doses administered to tumors ranged from 3,680 to 5,000 cGy. Ocular reactions after irradiation were classified as mild in 5 of 29 cases (17.2%) and severe in 17 of 29 cases (58.6%). No ocular complications were noticed in 7 of 29 cases (24.1%). Complications frequently noticed included severe keratitis (41%), mild conjunctivitis (34%), severe conjunctivitis (28%), cataract (28%), and keratoconjunctivitis sicca (24%). Ocular complications that developed were not life threatening, but posed a threat to visual function and patient quality of life. Treatment for the complications included control of bacterial infection, reduction of tissue inflammation, and ocular surface protection when tear film deficiencies were noticed. Mild complications represented acute effects of irradiation, and typically resolved. Severe complications developed both acutely and as late irradiation effects. Those attributed to late irradiation effects were more vision threatening and altered the quality of life more than did the early effects.
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PMID:Ophthalmic complications following megavoltage irradiation of the nasal and paranasal cavities in dogs. 310 20

Collagen shields made of porcine collagen were placed in a solution containing tobramycin sulfate (40 or 200 mg/ml) for five minutes, then applied to rabbit eyes. One, four, or eight hours after application, the corneas, aqueous humor samples, and shields were assayed for antibiotic. At all intervals, the concentration of antibiotic in the corneas and aqueous humor samples exceeded the mean inhibitory concentration for tobramycin, as determined for most strains of Pseudomonas. Shields immersed in 200 mg/ml tobramycin produced significantly higher concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .0001). Shields immersed in 40 mg/ml tobramycin produced higher, although not significantly higher, concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .318). Shields immersed in commercially available tobramycin drops or injectable tobramycin solution (40 mg/ml) caused no epithelial damage visible by slitlamp examination. Collagen shields containing antibiotics can serve as a vehicle for drug delivery and may prove superior to current methods for preoperative and postoperative antibiotic prophylaxis and the initial treatment of bacterial keratitis.
J Cataract Refract Surg 1988 Sep
PMID:Collagen shield drug delivery: therapeutic concentrations of tobramycin in the rabbit cornea and aqueous humor. 318 30

Corneal complications of herpes zoster ophthalmicus include pseudodendritic keratitis, late mucous adherent keratopathy, varied forms of stromal keratitis, and exposure/neurotrophic keratopathy. Prophylactic therapy of acute herpes zoster ophthalmicus with oral acyclovir is of proven benefit in reducing the incidence of early pseudodendritic keratopathy and stromal keratitis but has no evident effect on exposure/neurotrophic keratopathy. Although early pseudodendritic keratitis is due to virus infection of epithelial cells, it is self-limited and does not require topical antiviral therapy. Stromal keratitis and associated epithelial mucous adherent keratopathy are responsive to topical corticosteroids but chronic therapy is often required and may prolong the duration of keratitis and result in cataract or secondary glaucoma. Exposure and neurotrophic keratopathy may respond to topical lubricants and correction of lid abnormalities but severely affected corneas may require tarsorrhaphy or conjunctival flap to maintain corneal integrity.
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PMID:Corneal complications of herpes zoster ophthalmicus. Prevention and treatment. 325 20


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