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

Seventy-one nonimmunocompromised patients with herpes zoster ophthalmicus, presenting within seven days of onset of characteristic skin eruption, were enrolled in a prospective, longitudinal, randomized, double-masked, placebo-controlled trial with oral acyclovir. In a previous interim report we noted more prompt resolution of dermatomal signs and symptoms with acyclovir treatment. There was also a reduction of viral shedding in acyclovir-treated patients coupled with a trend to greater rate of microdissemination of the virus in placebo-treated patients (Cobo LM, et al. Ophthalmology 1985; 92:1574-83). While further substantiating these findings, we report that a ten-day course of treatment with oral acyclovir (600 mg, five times a day) is well-tolerated and significantly reduces the incidence and severity of the most common complications of herpes zoster ophthalmicus: dendritiform keratopathy, stromal keratitis, and uveitis. While this acyclovir treatment regimen reduces the zoster-related pain during the acute phase of the disease, especially in patients treated within 72 hours of onset of skin lesions, it has no evident effect on either incidence, severity, or duration of post-herpetic neuralgia in the patients studied.
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PMID:Oral acyclovir in the treatment of acute herpes zoster ophthalmicus. 348 32

We have studied certain aspects of the natural history of acute herpes zoster ophthalmicus in placebo-treated patients followed prospectively over one year as part of a therapeutic drug trial. Observations on the incidence of ocular complications relating to the efficacy of oral acyclovir in this disease have been previously published. This report provides supplemental observations on the natural history of frequently observed ocular complications of zoster ophthalmicus: corneal hypesthesia, episcleritis, dendritiform keratopathy, stromal keratitis, anterior uveitis, and post herpetic neuralgia. These ocular complications of zoster typically present within the first two weeks of the diagnosis. This report characterizes the onset of corneal hypesthesia, episcleritis, dendritiform keratopathy, stromal keratitis, and anterior uveitis as well as interrelationships amongst these sequellae of herpes zoster ophthalmicus. Post-herpetic neuralgia occurs in 52% of patients and persists beyond a year in 22% of those affected.
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PMID:Observations on the natural history of herpes zoster ophthalmicus. 349 83

Microbial keratitis is a major cause of corneal blindness in developing countries. One hundred thirty-one episodes of corneal infection in 120 patients over an 11-month period from Soweto, South Africa, were reviewed. Severe staphylococcal lid disease, trauma, and the secondary infection of climatic droplet keratopathy were the major precedents. Unilateral mixed patterns of infection, bilateral keratitis, and childhood keratitis were common. Staphylococci, streptococci, or gram-negative enteric bacilli were the usual causative organisms. Admission rates of corneal perforation were high. Small perforations often could be managed medically without tissue glue. In developing countries, logistic problems necessitate subconjunctival antibiotic therapy; the nursing staff may be too overextended to satisfactorily maintain topical antibiotic regimens. Effective, inexpensive antibiotic dosing schedules, which are appropriate for use by the general medical officer and ancillary health worker, must be developed.
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PMID:Causation and management of microbial keratitis in subtropical Africa. 350 59

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

A double-blind comparative trial of acyclovir (ACV) and adenine arabinoside (ARA-A) in combination with dilute betamethasone was carried out in 30 patients with herpetic disciform keratitis. Of those receiving ACV and betamethasone, 86.7% healed in a mean time of 22.5 days, while 76.9% of those receiving the Ara-A combination healed in a mean time of 26.7 days. There was no statistical difference between the two treatment groups for efficacy parameters. However, the proportion of patients developing superficial punctate keratopathy (SPK) was significantly greater in the Ara-A treatment group.
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PMID:A double-blind comparative trial of acyclovir and adenine arabinoside in combination with dilute betamethasone in the management of herpetic disciform keratitis. 354 62

Topically applied anaesthetics may lead to a serious keratopathy. Three patients presented to us with disciform keratitis, peripheral corneal ring, and stromal infiltration following the topical use of oxybuprocaine. All three patients developed marked decrease in vision secondary to corneal scarring. In all three patients oxybuprocaine was dispensed over the counter by a pharmacist. Legislation for the restriction of over-the-counter sale of topical anaesthetics, steroids, and antibiotics is essential in the prevention of many of the self-induced ocular disorders seen in developing countries.
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PMID:Oxybuprocaine keratopathy: a preventable disease. 395 77

A dog with exposure keratopathy developed secondary bilateral keratitis from which Aspergillus sp and Curvularia sp were identified. Mycotic keratitis, while rare in the dog, should be considered in the differential diagnosis of keratitis.
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PMID:Mycotic keratitis in a dog: concurrent Aspergillus sp and Curvularia sp infections. 403 17

Visual acuity was assessed after keratoplasty in 109 patients with various types of herpetic keratitis at different stages of the disease. Functional results appear to be independent of the age of the patient and the duration of the disease. On the contrary, they are related to the type of herpetic keratopathy present, and the surgical technique employed, whether lamellar or penetrating.
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PMID:[Prognostic factors after keratoplasty for herpetic keratitis (author's transl)]. 617 13

Forty patients with disciform keratitis were randomly assigned to double-blind treatment with 3% acyclovir and 0.01% betamethasone drops or acyclovir and matching placebo. All patients who received the combination healed in a median time of 21 days, while 11 of 19 patients who received acyclovir alone were withdrawn because their condition remained static or worsened (p less than 0.001). The combination therapy produced a faster rate of healing (p = 0.004); other clinical parameters also improved more favourably in the combination treatment group. Three patients had mild transient punctate keratopathy, but no serious adverse effects were seen despite treatment for a median duration of 28 days in the acyclovir group and 38 days in the combined therapy group. A combination of acyclovir and dilute steroid drops is effective in the management of disciform keratitis.
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PMID:Acyclovir (Zovirax) in herpetic disciform keratitis. 633 52

Hydrophilic 'bandage' lenses were fitted in 107 patients with corneal disorders not satisfactorily responding to conventional medical treatment. An over-all beneficial effect on both ocular discomfort, visual acuity and corneal disorder was found (P less than 0.002). Regarding each group separately only patients with bullous keratopathy and those with corneal ulcers achieved a significant reduction of ocular discomfort (P less than 0.002) and a significant improvement of visual acuity (P less than 0.05 - P less than 0.01). In bullous keratopathy corneal oedema was significantly reduced by concomitant use of contact lenses and 5% NaCl eye drops (P less than 0.01). Significant improvement of corneal disorder occurred in patients with corneal ulcers and in those with corneal lacerations (P less than 0.002 and P less than 0.01, respectively). Complications included corneal vascularization (7.5%) and keratitis/keratoconjunctivitis (5.6%). Prophylactic use of topical antibiotics appeared necessary only in dry eye disease.
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PMID:Hydrophilic contact lenses in corneal disorders. 648 54


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