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

The ocular emergencies encountered in Graves' ophthalmopathy, namely optic neuropathy, corneal ulceration, subluxation of the globe, and severe periorbital oedema with chemosis have been discussed. Evaluation of the clinical signs and symptoms of these conditions, as well as their treatment, have been outlined. Of particular concern is the complaint of 'blurry vision' that may indicate the presence of optic neuropathy. Early recognition of this entity, with prompt referral to an ophthalmologist is important because there is an inverse relationship between duration of visual loss and efficacy of treatment. The ophthalmological evaluation of a patient with optic neuropathy may demonstrate decreased visual acuity, impaired colour perception, or an afferent pupillary defect. In addition, a visual field examination may be a helpful adjunctive test. Available therapy for optic neuropathy includes high-dose corticosteroids, supervoltage X-irradiation and orbital decompressive surgery. We have reviewed the literature concerning these modalities and outlined our approach to the treatment of optic neuropathy. In general, we recommend orbital decompression at an early stage for this condition. Another worrisome complaint is of 'eye pain'. In this case, distinction must be made between the causes that include ocular inflammation, corneal keratitis and corneal ulceration. The corneal ulceration is characterized by extreme eye pain and erythema, and may require surgical intervention. Severe ocular inflammation may respond well to a course of high-dose steroids. A combination of these ocular emergencies in a patient with Graves' ophthalmology necessitates careful consideration of the available treatment options.
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PMID:Emergency treatment of Graves' ophthalmopathy. 173 99

Acanthamoeba keratitis occurs mainly in contact lens users. We experienced a patient with Acanthamoeba keratitis after operation for cataract. A 70-year-old male, who suffered from suppurative keratitis with impairment of visual acuity and eye pain in the left eye after the operation, was admitted to our hospital. After admission he received treatment with oral and topical antibiotics without any improvement. Neither bacterial or fungal pathogens was detected from corenal skrappings. Blue stained Acanthamoeba cysts were detected with the Parker ink KOH preparation from punctured fluid of the anterior chamber of the eye. Acanthamoeba cysts were also cultured on a nonnurient agar plate with Escherichia coli. Then he was treated with oral and topical miconazole and topical fluconazole. His visual acuity did not improve because of the lag of appropriate treatment. Therefore, attention must be paid for the existence of Acanthamoeba keratitis after ophthalmologic operations.
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PMID:[A case of Acanthamoeba keratitis after operation for cataract]. 749 19

Corneal abrasions are characterized by sudden onset of eye pain, photophobia and tearing. The patient usually relates a history of recent eye trauma but may not recall an inciting event. The differential diagnosis includes direct mechanical injury, recurrent erosion syndrome, ultraviolet keratitis and infection. Most abrasions heal within 24 to 48 hours. Therapeutic modalities include cycloplegia and topical antibiotics. Other treatment methods include pressure patching, topical nonsteroidal anti-inflammatory drugs, bandage contact lenses, collagen shields, anterior stromal puncture and epithelial debridement.
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PMID:Corneal abrasions: diagnosis and management. 905 16

We retrospectively reviewed 11 patients with culture-proven Acanthamoeba keratitis who presented at the National Taiwan University Hospital between 1989 and 1996. We assessed predisposing factors, initial diagnosis, clinical presentation, treatment, and outcome. A history of contact lens-wear, poor contact lens hygiene, intractable eye pain, and ring infiltrates in the cornea were the most prominent characteristics and clinical manifestations. Acanthamoeba keratitis was often misdiagnosed, with herpetic keratitis (7/11) being the most common initial diagnosis from referring hospitals. These patients were usually treated on the basis of the inaccurate diagnosis for more than 1 month (range 1-8 mo) before referral. All patients ultimately received penetrating keratoplasty because of poor response to delayed medical treatment. We suggest that inadequate contact lens hygiene may be important in Acanthamoeba keratitis. This condition is often misdiagnosed and, as early diagnosis is a major factor for successful medical treatment in such patients, awareness in clinical practice is critical.
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PMID:Clinical features and outcome of Acanthamoeba keratitis. 940 23

We isolated Acanthamoebae from the first two keratitis patients identified in Thailand in 1988 and 1990. The patients developed decreased vision, severe photophobia, severe eye pain and foreign body sensation after minor corneal trauma. The lesions included generalized superficial punctate keratitis, stromal corneal ulcer with keratic precipitate and uveitis in one case, and corneal ulcer with abscess in the other. Both cases were diagnosed by isolation of characteristic trophozoites and cysts of Acanthamoeba from corneal tissue by non-nutrient agar culture method. Based on cyst morphology, A. castellanii and A. polyphaga were detected in one case, and A. castellanii and A. triangularis in the other. Restriction fragment length polymorphism analysis of mitochondrial DNA (mtDNA-RFLP) revealed that each patient harboured a single parasite population. One shared mtDNA-RFLP with an authentic strain of A. castellanii, and the other gave a new unique pattern. Thus species identification of Acanthamoeba based on cyst morphology per se can be arbitrary, and mtDNA-RFLP may be more appropriate for accurate species/strain differentiation amongst morphologically heterogeneous populations of Acanthamoebae.
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PMID:Heterogeneity in cyst morphology within isolates of Acanthamoeba from keratitis patients in Thailand. 1088 96

Common types of contact lens are hard, rigid gas-permeable or soft lenses. Most lenses are worn on a daily basis. Cosmetic lenses are worn for non-medical indications. Microbial keratitis, a rare but most significant complication is discussed in this article. Pseudomonas aeruginosa and staphylococci are the most common organisms cause infective keratitis. Fungi and acanthamoeba are also responsible. The causes of increased susceptibility to infection are poor lens hygiene, adhesion of bacteria to lens surface and hypoxia. Preventing measures to be taken while wearing contact lens are discussed in a nutshell. Ocular pain, conjunctival infection, photophobia, epiphora and reduced vision are some of the symptoms of corneal infection. Diagnostic laboratory investigations are to be carried out immediately when a microbial corneal ulcer is suspected. Acanthamoeba can be cultured from corneal scrapes. Immunologically based fluorescein labelling techniques appear to be more sensitive than simple staining. The treatment consists of medical and surgical intervention. Corneal thinning, descemetocele formation and perforation are possible complications.
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PMID:Contact lens wear and microbial keratitis. 1279 39

Richner-Hanhart syndrome or oculocutaneous tyrosinemia is characterized by painful palmo-plantar keratoderma, keratitis with photophobia and progressive mental impairment. The syndrome is caused by deficient hepatic tyrosine aminotransferase and is inherited as an autosomal recessive trait. We report a 28 year-old woman with lifelong photophobia, eye pain and painful plantar hyperkeratotic lesions, necessitating use of a wheelchair. A few days after instituting tyrosine lowering therapy, her eye symptoms disappeared and she could walk without pain. Her brother was later diagnosed with the same disease.
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PMID:[Two cases of Richner-Hanhart syndrome (oculocutaneous tyrosinemia)]. 1836 60

We describe the first two cases of Tsukamurella keratitis, presented as eye pain with or without blurring of vision. One case was associated with trichiasis and the other with contact lens wear. The two isolates were identified as T. tyrosinosolvens and T. pulmonis, respectively, by phenotypic characterization and 16S rRNA sequencing.
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PMID:First report of Tsukamurella keratitis: association between T. tyrosinosolvens and T. pulmonis and ophthalmologic infections. 1936 36

Acanthamoeba keratitis (AK) is a sight-threatening corneal infection, the epidemiology of which is related to the specific genotype of Acanthamoeba. In this study, the genotypes of 14 Acanthamoeba isolates, each from a patient with AK, were identified according to the highly variable DF3 region in the 18S rRNA gene at Shandong Eye Institute, PR China, from 2000 to 2009, and the clinical characteristics of these patients were analysed. All 14 amoebae were genotype T4, representing nine different DF3 sequence types, seven of which were newly identified. Cornea infestation was the main risk factor for these 14 AK patients. Amoebic cysts could be detected in all corneal scrapes. Corneal ulcers were located mainly at the corneal centre, accompanied by eye pain, and some appeared with a Wessely ring. Surgery was carried out on all patients. Acanthamoeba genotypes T4/26 and T4/27 were found to cause a more severe keratitis, whilst the others showed no significant differences in clinical characteristics. In conclusion, the majority of the keratitis-causing Acanthamoeba isolates were genotype T4, with Acanthamoeba genotypes T4/26 and T4/27 from PR China causing a more severe keratitis.
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PMID:Genotyping of Acanthamoeba isolates and clinical characteristics of patients with Acanthamoeba keratitis in China. 2005 72

We describe a case of corneal chromoblastomycosis with Cladophialophora carrionii in a 69-year-old woman 4 weeks after clear corneal cataract surgery. The patient presented with right eye pain and decreased visual acuity of 20/100. Examination showed a deep posterior stromal keratitis accompanied by a dense fibrinous anterior chamber reaction. An aqueous tap was performed, and the patient was treated with topical, systemic, and intracameral antifungal and antibiotic agents. The infection was resistant to medical therapy and the course further complicated by secondary pupillary block glaucoma. After 10 days, a therapeutic penetrating keratoplasty was performed. The patient remained asymptomatic 20 months after the initial presentation, with corrected distance visual acuity restored to 20/40. To our knowledge, is the first reported case of corneal chromoblastomycosis with C carrionii. Early surgical treatment may be necessary to eradicate Cladophialophora species.
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PMID:Corneal chromoblastomycosis caused by Cladophialophora carrionii after cataract surgery. 2151 Nov 60


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