Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 53-year-old man with treated, biopsy-proven Whipple's disease is described during the exacerbation of the disease, and several new findings not previously reported in association with this disease are presented. The unique combination of ocular signs included uveitis, glaucoma, epiphora, superficial punctate keratitis, and an unusual fibrovascular pannus involving the anterior chamber angles and corneal periphery of both eyes. These ocular abnormalities emphasize the need for thorough ophthalmologic evaluation of all patients with Whipple's disease.
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PMID:Ocular findings in Whipple's disease. 7 73

Botulinum A exotoxin was recently approved for use in Canada. We describe the efficacy of botulinum toxin in the management of 235 patients with blepharospasm (mean age 64.3 years) and 130 patients with hemifacial spasm (mean age 60.4 years) treated at three Canadian ophthalmologic centres between 1984 and 1989. A total of 98% of the patients with blepharospasm and 100% of the patients with hemifacial spasm had significant relief of their symptoms; however, 11% of the former and 2% of the latter did not respond to the usual starting concentrations of the drug and needed stronger dosages for relief. The duration of relief varied widely in both groups. Up to 7% of patients had ineffective treatments but responded to subsequent injections. Analysis of variance and linear trend statistics showed that there were no changes in the mean duration of relief over the first several treatments for individual patients in either group. Side effects were transient and included ptosis, exposure keratitis, epiphora and strabismus.
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PMID:Treatment of blepharospasm and hemifacial spasm with botulinum A toxin: a Canadian multicentre study. 205 23

A 9-year-old boy was admitted to the Pediatric Department with high fever, severe photophobia, and a rash on his face, eyelids, and neck. Two days before admission he received injections of penicillin. During the night his general condition worsened, and his fever rose to 40 degrees C. He began to hallucinate, and clear fluid-filled blisters appeared on his skin and mouth. Severe photophobic epiphora, conjunctival injection, and punctate keratitis were also observed. Several hours after local administration of corticosteroids and antibiotic eye drops, his eyelids swelled severely, the corneas became covered by pseudomembranes, and later, in attempting to open the eyelids, the skin peeled off and the eye lashes fell out. Treatment consisted of artificial tear eye drops, and intravenous antibiotics and steroids. His condition improved gradually, visual acuity became 6/15 in both eyes, and a superficial punctate staining of the cornea was observed. The Schirimer test showed lacrimal hyposecretion. A tarsal conjunctival biopsy showed a complete absence of goblet cells. Vitamin A was administered topically and systemically. After three months of treatment with Vitamin A, tear secretion was almost normal, and conjunctival biopsy indicated a regeneration of goblet cells.
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PMID:Vitamin A in Stevens-Johnson Syndrome. 276 32

The effects of a modified-live infectious bovine rhinotracheitis virus vaccine (administered ocularly or intranasally) on experimentally induced infectious bovine keratoconjunctivitis were evaluated. The modified-live infectious bovine rhinotracheitis virus vaccine was administered to 13 male Holstein calves (intranasally in 4 and ocularly in 9; day 0). Five calves were not vaccinated and served as controls. Calves were examined daily and, starting on day 4, Moraxella bovis was administered ocularly to all 18 calves once daily for 4 days. The eyes of all calves were assigned a clinical score, and the ocular secretions were evaluated for presence of infectious bovine rhinotracheitis virus and M bovis daily until day 19. The severity of the ocular lesions was estimated by scoring the lesions clinically and by determining the protein concentration, myeloperoxidase activity, and WBC count in the tears. By day 5, conjunctivitis, chemosis, and epiphora were observed in all of the calves vaccinated ocularly. The calves vaccinated intranasally developed conjunctival plaques, but did not develop chemosis or photophobia. All of the calves developed keratitis after inoculation with M bovis. The median lesion scores were greater in both groups of vaccinated calves than in the controls. Corneal perforations developed exclusively in the vaccinated calves. The frequency of M bovis isolation from ocular secretions was significantly (P less than 0.05) greater in the vaccinated calves than in the controls. The tears from the intranasally vaccinated calves contained the highest myeloperoxidase activity and WBC count. The mean protein concentration in the tears of vaccinated calves was not significantly different from that in tears of controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Enhancement of infectious bovine keratoconjunctivitis by modified-live infectious bovine rhinotracheitis virus vaccine. 285 4

The authors used an antineoplastic-antibiotic agent, mitomycin, in the form of eye drops as adjunctive treatment for primary and recurrent pterygia after surgical excision. Sixteen primary and four recurrent pterygia were treated with 1.0 mg/ml mitomycin eye drops, 14 primary and 10 recurrent pterygia were treated with 0.4 mg/ml mitomycin eye drops, and 18 primary pterygia were treated with placebo eye drops. Postoperative follow-up for the eyes treated with mitomycin eye drops ranged from 3 to 34 weeks (mean, 23 weeks). One of 44 pterygia treated with mitomycin recurred after 5 months (recurrence rate, 2.3%), whereas 16 of 18 primary pterygia treated with placebo eye drops developed postoperative granulomas and recurrent pterygia with a mean postoperative period of 6 weeks (recurrence rate, 88.9%). Topical mitomycin (1.0 mg/ml) caused conjunctival irritation, excessive lacrimation, and mild superficial punctate keratitis. These topical side effects were minimized with the 0.4 mg/ml mitomycin dosage. No systemic toxicity was noted with either dosage. The authors believe that mitomycin eye drops is a safe and effective adjunct to surgical excision in the treatment of primary or recurrent pterygia, or both.
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PMID:Mitomycin eye drops as treatment for pterygium. 321 84

Multiple peripalpebral folds were the cause of severe bilateral blepharospasm and epiphora in a male Macaca fascicularis. The inner-most fold resulted in entropion and irritative keratitis. The condition was corrected surgically.
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PMID:Peripalpebral folds and entropion in a male crab-eating macaque (Macaca fascicularis). 677 75

Punctal occlusion was carried out in 32 eyes with tear deficiency syndromes regardless of the preoperative Schirmer tear test values. Diagnoses included: keratoconjunctivitis sicca, Stevens-Johnson syndrome, congenital alacremia, and post-traumatic tear deficiency. Subjective symptomatic improvement was recorded in 97% of the eyes. Objective improvement was recorded as resolution or improvement of corneal ulceration, filamentary keratitis, and superficial punctate keratitis. All patients (100%) experienced improvement in one or more of these diagnostic signs. A tarsorrhaphy was required as adjunctive therapy to punctal occlusion in three eyes with Stevens-Johnson syndrome. Epiphora did not occur after surgery even though 16 eyes (50%) had preoperative Schirmer tear test values greater than 2 mm (range 0-15 mm). Artificial tears were discontinued or reduced to occasional use in 85% of eyes postocclusion of puncta. Eight puncta reopened; five of the eight required reocclusion. In this series, punctal occlusion was a safe and effective method of managing severe tear deficiency syndromes and should be considered more frequently in patients with the appropriate criteria.
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PMID:Punctal occlusion in tear deficiency syndromes. 715 28

The authors reviewed 44 tarsoconjunctival grafts performed from 1983 to 1993 to determine the nature and severity of complications related to these grafts. Follow-up ranged from 3 weeks to 10 years, with a mean of 23 months. The complications were categorized as none, minor, or major. A complication was deemed major if it required a second surgical procedure for treatment. Eleven percent (5/44) of patients had major complications, including marked upper lid retraction after upper lid reconstruction (1), wound dehiscence (2), cicatricial ectropion (1), and excessive lower lid laxity (1). Seventy-three percent (32/44) of patients had minor complications. Minor complications included trichiasis (5), notching of the donor and/or recipient lid margin (9), mild lid retraction (3), contour deformity (2), granuloma (2), prolonged edema or erythema (4), symblepharon (1), mild ectropion (2), punctate keratitis (1), minimal ptosis (1), and epiphora (1). Sixteen percent (7/44) had no complications. Despite the frequent minor complications and the occasional major complications, the use of free tarsoconjunctival grafts remains a valuable procedure in the surgeon's armamentarium for reconstruction of major eyelid defects. Knowledge and early recognition of the possible complications may result in better patient care.
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PMID:Complications of tarsoconjunctival grafts. 865 58

Botulinum toxin has become the initial treatment of choice for the management of essential blepharospasm, hemifacial spasm and other craniocervical dystonias. Numerous studies have confirmed a 90% to 95% response rate. Although a number of common side effects have been reported, the occurrence and incidence of rare local complications remains poorly understood. More importantly, the acute and chronic distant effects of botulinum toxin have not been clearly elucidated. A better understanding of such effects is essential if clinicians are to appropriately advise patients on the use of this therapeutic modality. This article is based on the Duke University experience in the management of over 500 patients with craniocervical spasm disorders, combined with a review of the published literature. These disorders include essential blepharospasm, oromandibular dystonia, hemifacial spasm, and torticollis. The incidence of side effects following more than 6000 treatments with botulinum toxin is presented. Pertinent research relating to the causes of these complications is also reviewed. The most common complications of treatment with botulinum toxin are related to acute local effects resulting from chemodenervation. The most important clinical effect in this group is weakening of the levator muscle resulting in ptosis, and the corneal consequences of lagophthalmos. The latter includes exposure keratitis, dry eyes, blurred vision, and hypersecretion epiphora. Less common local effects include facial numbness, diplopia, and ectropion. Some distant effects are being observed with increasing frequency. These include pruritus, dysphagia, nausea, and a flu-like syndrome. Most significant, however, are the rare reports of generalized weakness and the documentation of EMG abnormalities distant to the site of toxin injection. This has been seen with injections for both blepharospasm and torticollis. Until further studies on the long-term distant complications of botulinum toxin are available, it is recommended that patients receive as few life-time doses of toxin as possible, consistent with adequate management of their spasms. The practice of reinjecting patients routinely every three months, or at the first return of mild spasms should be discouraged.
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PMID:Botulinum-A toxin in the treatment of craniocervical muscle spasms: short- and long-term, local and systemic effects. 882 30

Eosinophilic keratoconjunctivitis was diagnosed in 7 horses at The Ohio State University between 1976 and 1994. All horses had moderate-to-severe blepharospasm, chemosis, and conjunctival hyperemia; epiphora; and extensive yellow-to-white caseous mucoid discharge. Corneal ulcers associated with this disease were perilimbal and extended centrally. All ulcers were covered with a white necrotic plaque firmly attached to the underlying cornea. Other ophthalmic abnormalities were not detected. Corneal scrapings examined cytologically contained numerous eosinophils interspersed between epithelial cells, few mast cells, and neutrophils. Microbial organism were not seen. Bacterial and fungal cultures were negative for ocular pathogens. The initial diagnosis of eosinophilic keratoconjunctivitis was made on the basis of clinical and cytologic findings. In 5 horses, the condition completely resolved after topical treatment with corticosteroid (0.05% dexamethasone) and triple antibiotic ointments. However, the duration of treatment was prolonged, with a mean treatment time of 64 days (range, 45 to 106 days). All corneal ulcers remained superficial, and despite the prolonged duration of treatment, none of the horses developed secondary bacterial or fungal keratitis. One horse underwent superficial keratectomy and had the shortest resolution time (14 days).
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PMID:Eosinophilic keratoconjunctivitis in seven horses. 883 52


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