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

The authors relate the results obtained with very thin soft hydrogel lenses (0,10 mm thickness) of high and low water content: the Vergo-Softcon THX of 70% water-content and the Bauch and Lomb Plano-T of 38%. The most frequent indications encountered are bullous keratopathy, epithelial defects and keratitis sicca. The results are positive in 78,2% of cases with 70% w/c soft hydrogel lenses. Results are given for cases of direct fitting of thin lenses, as well as for cases of fitting after failures of classic soft hydrogel lenses and in cases of exchanges of 40% lenses for 70% lenses. The 70% water content lenses seem to give better results main in cases of epithelial defects and keratitis sicca.
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PMID:[Thin soft hydrogel lenses of high and low water (author's transl)]. 15 54

2,277 specimens from 901 eyes were cultured for herpes simplex virus (HSV). 161 of 391 herpes-diseased eyes yielded HSV. The clinico-virological correlation led to a simple diagnostic and therapeutic scheme which is applicable by the ophthalmologist in his office without virological confirmation: 1. Superficial viral herpes (dendritic keratitis and allied disorders), HSV-isolating rate 96%. 2. Stromal herpes (disciform edema, different types of interstitial herpetic keratitis), only sporadical findings of HSV in the lacrimal fluid. The rate of virus-recovery increases, however, when an interstitial herpetic keratitis ulcerates. 3. Metaherpetic corneal disease = chronic or chronic recurrent superficial postherpetic disease without any detectable HSV-activity (main types: metaherpetic erosion, metaherpetic ulcer, metaherpetic bullous keratopathy). One of four superficial herpetic corneal diseases proved to be nonviral, i.e. metaherpetic in our series. Metaherpetic diseases may be widely considered as a therapeutic entity. The differential diagnosis with the slitlamp only and the proposed therapy (highly hydrophilic soft lenses plus adequate additional eye drops) are discussed in detail. Being aware of the diagnostic criteria and taking advantage of a combined soft lens therapy the treatment of metaherpetic corneal disease is easier and more successful than commonly accepted.
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PMID:[Metaherpetic keratitis clinical and virological findings (author's transl)]. 19 Apr 37

The ophthalmologist differs between three forms of manifestation of the herpetic infection: 1. The superficial keratitis with involvement of the epithelium, known as keratitis punctata, stellata or dendritica. 2. The deep for: the keratitis disciformis. This is a delaged hypersensitivity against the herpes virus or its products of metabolism. 3. The metaherpetic keratopathy develops on the basis of a disturbed metabolism after relapsing, mainly deep herpetic keratitis. Therapy differs according to the forms of manifestation. The prevention of relapses is a problem. The frequency of relapses of the corneal herpes is considerably less and the intervals between the relapses are in general considerably longer than in dermatological herpes affections. Therefore, the influence on the recidivity by the drug Lupidon can be appreciated by a long-term study over several years only.
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PMID:[Herpetic eye diseases]. 19 8

The introduction of the hydrophilic contact lens has been a significant advance in ophthalmology for the correction of ametropia, as well as for the therapy of corneal disease. The number of potential contact lens candidates has been greatly expanded by the introduction of both spin-cast and lathe-cut lenses composed of a variety of individual hydrophilic polymers. Myopia, hyperopia, presbyopia, aphakia and moderate astigmatism can be corrected with a reasonable degree of success with the present lenses. Even in keratoconus hydrophilic lenses offer a nonsurgical alternative, especially when combined with spectacle overcorrection. The introduction of hydrophilic bandages in the treatment of corneal disease has been an important addition to the therapeutic armamentarium of the ophthalmologist. When properly applied, these lenses can provide subjective relief of pain while serving to protect the damaged cornea from the traumatic action of the lids and desiccating effects of the atmosphere. The hydrophilic material is permeable to many topically instilled medications and tends to prolong the contact time of the drugs with the corneal surface. Proper fitting of the bandage lenses can eliminate superficial corneal irregularities and, thus, improve the visual acuity while treatment progresses. Medical indications for the use of this therapy include bullous keratopathy, dry eye syndromes, chemical burns, exposure keratitis, and neurotropic keratitis. A number of recurrent erosions and ulcerations have also responded to this form of therapy. Surgical indications include lacerations, postoperative lamellar and penetrating keratoplasty, and keratectomies. One of the most promising applications concerns their use in the postoperative management of alkaline burns. Best results have been obtained by constant wear of the bandage lens, with topical administration of steroids, antibiotics, and saline solution (hypotonic or hypertonic) as indicated. The possible deleterious effects of standard ocular medication containing preservatives has been overstated. Patients receiving medications without preservatives must be placed on prophylactic antibiotics to avoid secondary infection. In many cases, the therapeutic efficacy is closely related to the diameter and curvature of the bandage lens as well as the inherent physical properties of the polymers. With meticulous fitting and close observation complications have been minimal. In many instances the results have been dramatic, but even if unsuccessful the method provides a safe and relatively simple nonsurgical alternative in the treatment of severe corneal disease. Just as with older modalities, the ultimate success or failure depends upon the intrinsic nature of the disease process as well as reasonable therapeutic application based on a knowledge of the mechanics involved.
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PMID:New aspects of contact lenses in ophthalmology. 95 43

Of 278 consecutive therapeutic soft lens wearers, 19 (6.8%) developed discrete lens opacities on the anterior (air) surface of the lens. The incidence rose to 16.6% in patients fitted for dry eye syndromes, to 19% in bullous keratopathy and to 20% in exposure keratitis and trichiasis, if worn for longer than 2 weeks. These opacities were not associated with medications. Scanning electron microscopy demonstrated cracks on the anterior lens surface associated with these opacities. Transmission electron microscopy demonstrated the opacities to be amorphous material with extensions of the contact lens polymer into the substance of these opacities. Lipid, as demonstrated by histochemical methods, was found in these opacities. It is likely that the combination of dryness, stress on the lens surface, and lipid deposition act to alter the structure of the plastic and cause these opacities.
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PMID:The nature of "spots" on soft lenses. 109 89

The vesicant agents of the unitary chemical munitions stockpile include various formulations of sulfur mustard [bis-(2-chloroethyl) sulfide; agents H, HD, and HT] and small quantities of the organic arsenical Lewisite [dichloro(2-chlorovinyl) arsine; agent L]. These agents can be dispersed in liquid, aerosol, or vapor form and are capable of producing severe chemical burns upon direct contact with tissue. Moist tissues such as the eyes, respiratory tract, and axillary areas are particularly affected. Available data summarizing acute dose response in humans and laboratory animals are summarized. Vesicant agents are also capable of generating delayed effects such as chronic bronchitis, carcinogenesis, or keratitis/keratopathy of the eye under appropriate conditions of exposure and dose. These effects may not become manifest until years following exposure. Risk analysis derived from carcinogenesis data indicates that sulfur mustard possesses a carcinogenic potency similar to that of benzo[a]pyrene. Because mustard agents are alkylating compounds, they destroy individual cells by reaction with cellular proteins, enzymes, RNA, and DNA. Once begun, tissue reaction is irreversible. Mustard agents are mutagenic; data for cellular and laboratory animal assays are presented. Reproductive effects have not been demonstrated in the offspring of laboratory rats. Acute Lewisite exposure has been implicated in cases of Bowen's disease, an intraepidermal squamous cell carcinoma. Lewisite is not known to generate reproductive or teratogenic effects.
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PMID:Toxicity of vesicant agents scheduled for destruction by the Chemical Stockpile Disposal Program. 148 58

We report three patients with persistent epithelial defects in the context of neurotrophic keratopathy that healed while on treatment with topically applied, mouse-derived epidermal growth factor (m-EGF). The clinical course of these patients was striking and suggests that EGF may have a potential role in the treatment of persistent epithelial defects in subjects suffering from neurotrophic keratitis.
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PMID:Treatment of persistent epithelial defects in neurotrophic keratitis with epidermal growth factor: a preliminary open study. 150 60

We describe a tarsorrhaphy technique whereby an ipsilateral upper-eyelid tarsal pillar is sutured to a corresponding lower-eyelid recipient site. This technique allows maintenance of a narrowed interpalpebral fissure indefinitely, yet is easy to reverse without incurring lid-margin damage. Additionally, the procedure can be adjusted postoperatively to either narrow or widen the initial surgical result. We report our combined surgical experience in 35 consecutive procedures using this technique to treat eyes with exposure-related keratopathy of varied etiology, including facial nerve palsies, combined facial nerve palsy and trigeminal neuropathy with an anesthetic cornea, Graves' disease, congenital craniofacial anomalies, and severe keratitis sicca syndrome. The procedure was successful in improving exposure keratopathy symptoms in all 35 cases. Complications, reflecting the authors' learning curve with this new procedure, included intermarginal pyogenic granulomas, stretching of the tarsal pillar, minor lower-eyelid-margin eversion, and tarsal pillar dehiscence.
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PMID:The tarsal pillar technique for narrowing and maintenance of the interpalpebral fissure. 151 40

Peripheral ulcerative keratopathy and necrotizing scleritis have been reported in rheumatoid arthritis patients after cataract surgery, but the incidence of these complications during the immediate postoperative period is unknown. We retrospectively studied 70 patients with rheumatoid arthritis who underwent a total of 86 cataract extractions between 1973 and 1988. Only 15 of the patients had a preoperative history of keratoconjunctivitis sicca. The best corrected postoperative visual acuity was greater than or equal to 20/30 in 81% of eyes. No episodes of scleritis or peripheral ulcerative keratopathy occurred during the 8-week postoperative period. Three patients (all from the sicca group) developed diffuse superficial punctate keratopathy and/or filamentary keratitis. Results suggest that serious corneal complications after cataract surgery are uncommon in rheumatoid arthritis patients similar to the population found in our study (95% Poisson confidence interval 0-6.6%).
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PMID:Corneal complications after cataract surgery in patients with rheumatoid arthritis. 158 18

We treated three patients with herpes simplex dendritic keratitis that occurred between three and 11 months after keratoplasty. The patients had no history of herpetic infection. The eyes of two of the patients were grafted for corneal scarring of undetermined origin. The eye of the third patient was grafted for pseudophakic bullous keratopathy. At the time of onset of dendritic keratitis, all three patients were receiving either maintenance or higher doses of topical corticosteroids. All infections responded to topical antiviral treatment. The findings in these patients illustrate the importance of considering herpes simplex keratitis in the differential diagnosis of all late-onset epithelial defects in the corneal graft, even in the absence of a history of herpes simplex keratitis.
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PMID:Herpes simplex dendritic keratitis after keratoplasty. 165 99


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