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)

Thirty-nine patients with trigeminal neuralgia, not controlled by medical treatment, were treated by radio-frequency thermocoagulation of the Gasserian ganglion and its posterior rootlets. Thirty-six received satisfactory pain relief. In 30 patients touch sensation in the treated territory was preserved. The corneal reflex was affected in only six patients, two of whom subsequently developed keratitis. There were no other complications apart from a minor unpleasant sensation in eight patients. By selectively destroying pain fibres this technique offers the scope of preserving touch sensation in the treated area. Moreover, the zone of analgesia can be restricted to the affected region by sensory mapping through electrode stimulation before thermocoagulation. Its simplicity, low morbidity, associated short hospital stay, and the increased ability to preserve touch sensation, especially of the cornea, seem to make it preferable to other forms of surgical management for trigeminal neuralgia.
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PMID:Radiofrequency thermocoagulation of Gasserian ganglion and its rootlets for trigeminal neuralgia. 6 74

The nonophthalmic physician confronted by a patient with a red eye should be able to distinguish common microbial or allergic conjunctivitis from potentially blinding disorders, such as acute angle closure glaucoma, uveitis, or herpes simplex keratitis, and should remain alert for an associated systemic disease, such as rheumatoid arthritis, polycythemia, or carotid cavernous fistula. The physician should approach the red eye systematically: take a careful history, including type of pain; measure visual acuity; observe the pattern of redness, the type of discharge, the shape of the pupil, and the opacities of the media; and measure the intraocular pressure.
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PMID:The red eye. 30 93

The topical action of a combined therapy of human interferon (3000 U/ml) and secretory immunoglobulin IgA (1,5 mg/ml) was studied in 56 patients with herpetic keratitis. The pain and photophobia disappeared within 48 h after the beginning of treatment and a marked reduction of the corneal lesion during the first week of treatment was observed in all the patients. The therapy was effective, with complete healing of the lesion in 94.8% of cases; 72.2% of them healed in less than 15 days. The highest frequency of healing was between 5 and 10 days, and the rest up to 30 days. Humoral, immunological and delayed hypersensitivity studies were carried out in 36 patients.
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PMID:Combined therapy of human interferon (HI) and secretory immunoglobulin (S-IgA) in the treatment of human herpetic keratitis. 35 19

The patterns of sensory loss in 29 cases of Juxta pontine trigeminal rhizotomy are reported. The section of 70% of the portio major gave a similar impairment of tactile, thermal and pain sensibility in the facial area corresponding to the portio of the nerve section in all the patients. These findings do not support Jannetta and Rand's statement that partial to complete section of the porto major at the pons with complete preservation of the intermediate fibre does not affect the perception of light touch. The reported data suggest: 1--intermediate fibres are not mode specific fibres for light touch; 2--clear separation between thermoalgesic and tactile afferent rootlets does not exist in the trigeminal root; 3--saving the portio minor and the intermediate fibres ensures the preservation of perception of tactile, thermal and pain sensibility, thus avoiding postoperative painful anesthesia and keratitis.
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PMID:[Trigeminal neuralgia: interpretation of the results of the Dandy method of rhizotomy]. 52 49

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

Percutaneous radiofrequency ablation of the Gasserian ganglion or posterior root, or both, was performed in 140 patients. Of the 135 patients with trigeminal neuralgia, satisfactory analgesia was achieved in 121. Postoperative complications included unintentional first-division analgesia (10), transient sixth-nerve palsy (1), neuroparalytic keratitis (2), and anesthesia dolorosa (2). The phenomenon of facial blush may be helpful in avoiding unwanted first-division analgesia. In four of five patients with other forms of neuralgia, the procedure did not relieve pain; the fifth patient experienced significant relief from pain due to carcinoma of the mandible.
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PMID:Radiofrequency percutaneous Gasserian ganglion lesions. Results in 140 patients with trigeminal pain. 111 46

A corneal abrasion is the most common eye complication during general anesthesia and recovery. It is painful, may progress to inflammation of the uveal tract, and in the presence of contamination may lead to a serious infection. Both eyes may be involved, as the two reported cases show. Possible causes include mask friction on the open eye or other careless technics. Treatment includes local application of an antibiotic ointment and an eye pressure patch. In addition, a cycloplegic and mydriatic solution is instilled to prevent synechiae (in the presence of a secondary iridocyclitis) and to relieve the pain associated with spasm of the iris and ciliary muscle. Topical application of local anesthetics should be avoided, as they delay regeneration of corneal epithelium and may promote keratitis.
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PMID:Corneal injuries during general anesthesia. 117 Jul 81

We cared for two patients with longstanding vernal keratoconjunctivitis who had bacterial corneal ulcers in each eye. Both patients were young, black, and had histories of atopy. The patients came for treatment with acute symptoms of pain, redness, and reduced vision in the affected eye. On examination in each case we found an epithelial defect associated with dense stromal infiltration, a calcific plaque in the bed of the ulcer, and a severe anterior chamber reaction, including a hypopyon in two cases. Cultures of corneal scrapings from all four eyes were positive for Staphylococcus aureus, and three of the four infections were polymicrobial. All four eyes responded rapidly to intensive topical antibiotic therapy, debridement of the calcific plaque, and subsequent treatment with topical corticosteroids and/or cromolyn sodium. Bacterial keratitis can occur in patients with vernal keratoconjunctivitis, especially those with vernal corneal ulcers. The abnormalities of ocular immune mechanisms found in patients with vernal keratoconjunctivitis may predispose them to bacterial keratitis.
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PMID:Bacterial keratitis associated with vernal keratoconjunctivitis. 142 58

Congenital insensitivity to pain is a well-defined entity in the group of sensory deficiency syndromes. To the best of our knowledge, unilateral neuroparalytic keratitis associated with congenital insensitivity to pain has not been reported. We report such a case to alert clinicians to this potentially blinding problem.
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PMID:Congenital insensitivity to pain with neuroparalytic keratitis. 169 65

Persistent trigeminal neuralgia, herpes zoster neuralgia of the first division of the trigeminal nerve and pain caused by cancer situated in the head and neck pose frustrating problems for patients and physicians. Tractotomy and/or partial vertical nucleotomy of the subnucleus caudalis nervi trigemini offers a logical approach to the treatment of such pain, since these structures contain fibres of the Vth nerve, as well as the somatosensory fibres of the VIIth, IXth and Xth nerve. Tactile and some thermal sensitivity of the face is preserved and anaesthesia dolorosa and keratitis neuroparalytica is avoided. Over the past 30 years 370 patients with therapy-refractory trigeminal pain, pain due to cancer of the head and neck and herpes zoster trigeminal pain were treated by means of tractotomy (personal series of V. Grunert), including 30 patients who underwent partial vertical nucleotomy. The mean age of the patients was 68 years (range 54-84 years). The mortality in this series was 0.9% (4 patients; one operative mortality due to air embolism, one postoperative cardiac failure following myocardial infarction and two intracerebral haematomas). 60% of the patients with persistent trigeminal neuralgia were pain-free and 28% improved, whereas 12% were unchanged or suffered from recurrent pain. Of the patients with cancer who complained of pain derived from the Vth, VIIth, IXth and Xth nerve, 40% demonstrated marked pain relief and 60% showed no improvement. Tractotomy and partial vertical nucleotomy offer a valuable method in experienced hands for relieving pain where other methods have failed.
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PMID:[Tractotomy and partial nucleotomy as a form of therapy in refractory pain of the trigeminal nerve and cancer pain in the head and neck area]. 170 47


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