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

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.
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PMID:Management of noninfectious corneal ulcers. 331 57

A healthy 42 yr-old woman presented with a left keratitis which she had had for 3 months. No organisms could be grown by culture of corneal scrapings for bacteria and fungi, and the condition failed to respond to topical therapy. Amebic keratitis was diagnosed following corneal biopsy and cultures which grew Acanthamoeba of a species similar to, but not identical with, Acanthamoeba polyphaga. Medical treatment was continued for 6 mth. During this time the corneal infiltrate became less prominent but visual acuity remained impaired by both corneal opacity and cataract.
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PMID:Microbiological and histopathological confirmation of acanthamebic keratitis. 337 76

A 21-year-old man who had radial keratotomy performed two years previously presented with a painful, red right eye. Suppurative keratitis was found in one of the eight radial incisions and Staphylococcus epidermidis was isolated by culture. Lack of stromal healing of the infected incision and the presence of epithelial cysts in four other incisions in the same eye suggest that the cause of the corneal infection was loss of the epithelial barrier function because of epithelial breakdown.
J Cataract Refract Surg 1988 May
PMID:Suppurative keratitis: a late complication of radial keratotomy. 339 95

To understand how human corneal endothelium compensates for cell loss, nuclear DNA-cytofluorometry and cell morphometry were carried out on injured corneal endothelium. The examined corneas included two cases of keratoconus complicated with acute hydrops and one without acute hydrops, two cases of herpetic keratitis, one case of post-intracapsular cataract extraction (post-ICCE) and one case of luetic keratitis. The endothelial cell layer was separated from Descemet's membrane and double-stained with Rhodamine-labeled wheat germ agglutinin-lectin (WGA) and 4',6-diamidino-2-phenylindole dihydrochloride (DAPI). The area of each cell was measured with a color image analyser and compared with its cytofluorometric nuclear DNA content. The endothelium in apparently intact regions of the diseased corneas showed the same DNA-ploidy pattern and cell area as the physiological corneas. However, endothelial cells in injured regions had greater area, even in diploidy, than in presumably normal ones and showed a larger number of hyperploid cells ranging from 4C to 36C. Hyperploid cells consisted of many multinucleates and few polyploidies and had extremely large and bizarre cytoplasm. All injured corneas were accompanied by cells with numerous micronuclei. A few asymmetrical 4C-binucleates (with DNA values such as 1.3 plus 2.6C) appeared in the case of the post-ICCE. It is concluded that damage to human corneal endothelial cells in vivo results in cell enlargement with or without DNA synthesis. Those changes appear more severe in diseased corneas than in the situation of physiological aging which we have reported previously. In severe cases, micronuclei, polyploid cells and multinucleated giant cells are frequent, thereby suggesting a possible long-persistent metabolic impairment of the endothelium after severe damage to the cornea.
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PMID:Changes in nuclear DNA content and cell size of injured human corneal endothelium. 340 92

In a new surgical procedure, adverse reactions or complications may surface without most ophthalmic surgeons experiencing them or being aware of them. Even those with a large series of cases may never see certain problems. Through a collaborative effort with over 200 radial keratotomy surgeons totaling 63,000 cases nearly every significant complication has been documented. This study of radial keratotomy complications includes the number of patients and percentage of the total of the following: intraoperative occurrences which generally do not affect vision, which include microperforations and macroperforations; postoperative changes which do not affect vision: limbal "peeking" and star pattern with light; transient occurrences which tend to resolve with time: ptosis, recurrent erosions, corneal ulcer, microwound abscess, delayed wound healing, inferior rectus palsy, glare or fluctuating vision after six months, iritis, and stromal keratitis; postoperative changes which can affect vision (correctible): overcorrection more than 1.5 diopters, marked undercorrection more than -2.00 diopters, irregular astigmatism, neovascularization after soft-contact-lens wear, and best-corrected acuity decreased usually only one line; and postoperative changes which can affect vision (uncorrectible): retrobulbar hemorrhage and endophthalmitis, loss of the eye, herpes keratitis, and cataract formation.
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PMID:Radial keratotomy complications. 342 39

Data taken from 1221 patients attending the Zoster Clinic of Moorfields Eye Hospital over the past 15 years were used to characterise the clinical appearance and behaviour of zoster mucous plaque keratitis (MPK). The typical greyish branching plaques are usually accompanied by a limbitis, stromal keratitis, or decrease in corneal sensation and are commonly associated with cataract, raised intraocular pressure, or corneal ulceration. MPK may begin at any time within two years of onset of the rash, but when it appears after three months there are more complications. Usually MPK settles within one month if appropriate treatment with topical steroids and acetylcysteine drops is given, but surgical intervention is sometimes required to control glaucoma or neuroparalytic keratitis or to remove cataracts. The results of surgery are surprisingly good.
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PMID:Ophthalmic zoster: mucous plaque keratitis. 349 32

We performed a retrospective analysis of the clinical and pathologic diagnoses of 497 corneal buttons that had been submitted to the Estelle Doheny Eye Pathology Laboratory, Los Angeles, during the five-year period 1979 through 1983. The leading indications, in order of decreasing frequency, were pseudophakic bullous keratopathy (17.5%), regrafts (15.1%), aphakic bullous keratopathy (10.9%), corneal trauma (9.3%), and Fuchs' endothelial dystrophy (9.1%). The emergence of pseudophakic bullous keratopathy as the most common cause for penetrating keratoplasty correlates well with the dramatic increase in the number of cataract extractions with intraocular lens implantations performed since the mid-1970s. Less frequent indications for penetrating keratoplasty included the following: corneal scars (6%); active ulcerative keratitis (7%); keratoconus (6%); keratitis secondary to virus (5%); non-Fuchs' corneal dystrophies (3%); congenital corneal opacities (3%); interstitial keratitis (2%); and chemical burns (1%).
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PMID:An update of the indications for penetrating keratoplasty. 1979 through 1983. 351 Jun 13

Corneal epithelium antibodies were detected in patients with corneal melting disease (55%), uveitis (42%), corneal transplantation (42%) and marginal furrow disease (20%). These antibodies were not found in herpetic keratitis patients. In control groups, consisting of ocular surgery patients (glaucoma, retinal detachment and cataract) and persons without a history of ocular disease, approximately 4% of the subjects had these antibodies. To investigate the possible role of trauma to the cornea as an initiator of corneal epithelium antibodies, these antibodies were determined in rabbits after alkaline burns were made on the cornea. These antibodies were detected one week later and disappeared after six weeks. Serum from three patients with corneal melting disease and corneal transplantation containing a high antibody titre against corneal epithelium were used to isolate corneal epithelium antigens. A 54 kD and a 17 kD corneal epithelium antigen were isolated. The incidence of autoantibodies directed against these antigens was investigated in patients with corneal melting disease, uveitis and corneal transplantation using an ELISA. 50% of the sera positive in the immunofluorescence test were positive in the ELISA.
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PMID:Clinical and experimental studies concerning circulating antibodies to corneal epithelium antigens. 355 14

RGH-6201 (4-diethylaminoethoxy-alpha-ethyl-benzhydrol) in the first dose-range finding study on rats produced severe, irreversible ophthalmic damage. The underlying mechanism was studied in a series of experiments with daily doses of 50, 100 and 200 mg/kg in rats by gavage. Lenticular damage appeared as a moderate nuclear degeneration during Week 4 of treatment with 50 mg/kg RGH-6201. This could be detected in the isolated eye and in histological examination but not by ophthalmoscopy. Keratitis and iridocyclitis developed about the 2nd week of treatment followed by epithelial proliferation in the lens under the anterior capsule in the higher dose groups. Nuclear and total cataract developed from the 2nd week on in the 200 mg/kg group and from the 3rd week on in the 100 mg/kg group. Further gross pathological changes in the high dose group were characterized by marked hairloss, desquamation in the cardiac region of the stomach and diarrhoea. It has to be emphasized that fine lenticular changes were unrelated to keratitis and iridocyclitis. Since other benzhydrol derivatives such as 2,5-dimethyl-alpha-ethylbenzhydrol and 3-trifluoro-methyl-alpha-ethyl-benzhydrol do not induce similar changes, the diethyl-amino-ethoxy group was assumed to be the toxic part of the molecule. Intravenous studies with equimolar doses of diethyl-aminoethanol revealed no similar symptoms.
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PMID:Analysis of cataract and keratotic damage induced by 4-diethylaminoethoxy-alpha-ethyl-benzhydrol (RGH-6201) in rats. 386 78

251 eyes underwent the combined procedure of perforating keratoplasty and intracapsular cataract extraction from 1968 to 1983. The preoperative preliminaries as well as the intraoperative details are described. The histological diagnoses were Fuchs' endothelial-epithelial dystrophy, keratoconus, leukoma adherens and different kinds of keratitis. 89% of the grafts were clear, 11% irreversibly cloudy. Visual acuity was improved in 88%. Postoperative high intraocular pressure was no special problem and not affected by the combined procedure. Vitreal complications were seen in only 14%. The diameter for transplant and patient's cornea can be reduced to 7.3 mm for both.
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PMID:Combined perforating keratoplasty and intracapsular cataract extraction. 388 13


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