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

The author evaluated 142 patients aged 65 years or older with microbial keratitis. There were relatively high rates of Pseudomonas aeruginosa infection unassociated with contact lens wear and of Streptococcus pneumoniae infection. The rates of quasicommensal and enteric infections were not proportionately elevated. Corneal disease, use of topical corticosteroids and use of contact lenses were the main predisposing factors. Patients with diabetes mellitus, dementia or chronic alcoholism appeared to be at higher risk. Trauma was rarely a factor. Complications requiring surgery were common. Corneal perforation developed in 20% of the patients, and endophthalmitis developed in 6%. The elderly often do not tolerate intensive topical antibiotic treatment well. Supplementary subconjunctival antibiotic injections under local anesthesia may be necessary. Corneal tissue glue, tarsorrhaphy and conjunctival flaps are probably underused in this age group.
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PMID:Causes and management of bacterial keratitis in the elderly. 273 Oct 71

In 11 patients with relapsing herpetic keratitis and metaherpetic ulcers cryoimmunotherapy, as recommended by Amoils, was applied. Under instillation anaesthesia three cryocycles were made using a temperature of -80 degrees on the entire area of the lesion with subsequent instillation of 60 drops (1 drop per minute) of serum obtained from 15 ml of the patient's blood mixed with 5 ml gamma globulin. In all 11 patients progression of the disease was arrested, though it could not be checked by previous conservative therapy. The cornea cleared and vision improved. The method is effective, simple and expands therapeutic procedures which can be used in these tiresome conditions.
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PMID:[Cryoimmunotherapy of herpetic and metaherpetic keratitis]. 274 36

Two patients developed exposure keratitis in the nonoperated eye during intraocular surgery under local anesthesia. These cases demonstrate that potentially serious injuries may occur to the fellow eye even with the use of local anesthesia and that special precautions should be taken to avoid this problem.
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PMID:Exposure keratitis following cataract surgery on the fellow eye. 344 2

The therapy of face and neck pain has often been elusive. We attempted to improve the condition of these patients and tried to influence 1. pain of trigeminal neuralgia, where other forms of therapy had failed, 2. pain due to tumours in the distribution of the Vth, IXth and Xth nerve, when all other methods had proved to be unsuccessful, 3. pain due to a traumatic lesion of the Vth nerve after severe injury of the face and 4. pain in the first division of the Vth nerve after herpes zoster infection, when other forms of therapy had failed. After tractotomy the subnucleus caudalis n.V. is partially destroyed. Aim of the partial vertical nucleotomy is the interruption between the first and second neuron of the Vth nerve conveying pain and thermal sensibility, but also of the IXth and Xth nerve, which end in the subnucleus caudalis n.V. as well. Tactile and some thermal sensibility in the face is so retained, and anesthesia dolorosa or keratitis neuroparalytica avoided. Medially of and vertically to the tractotomy a 4-6 mm long incision both cranially and caudally of the tractotomy was made. For the first division of the Vth nerve the nucleotomy is performed on the lateral end of the tractotomy incision. In the patients with cancer of the face and neck a rhizotomy C 1/2 was added. 7 of the 12 patients with trigeminal neuralgia and 3 of the 6 patients with tumors of the face and neck were pain-free. The rest also showed a marked improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Tractotomy and partial vertical nucleotomy--for treatment of special forms of trigeminal neuralgia and cancer pain of face and neck. 347 77

Percutaneous radiofrequency lesion of the Gasserian ganglion was performed between 1974 and 1984 in ninety-eight patients for the relief of trigeminal neuralgia. The average follow-up period was 4.5 years. Age, sex, and duration of illness were unrelated to outcome. Satisfactory analgesia was achieved in 68 patients. Thirty-one percent had return of pain (30 cases). Recurrent neuralgia occurred most frequently during first postoperative year (46%). Patients with marked sensory deficits had a reduced risk of recurrence. Postoperative complications included: reduced or absent corneal reflex (18 cases), corneal keratitis (3 cases) and anesthesia dolorosa (2 cases).
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PMID:Long-term results of percutaneous gasserian ganglion lesions. 349 62

Two young children with unilateral photophobia, redness, blepharospasm and corneal epithelial defects unresponsive to conservative therapy were seen between December 1982 and June 1983. Herpes simplex virus was established as the causal agent in both cases, only after the children had been examined under general anesthesia and appropriate cultures obtained. The difficulties in diagnosing herpetic keratitis in children and the treatment and long-term prognosis are discussed.
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PMID:Nonhealing corneal defects due to herpes simplex in children. 360 99

A total of 39 patients with essential blepharospasm and 2 patients with hemifacial spasm were treated with one or more forms of therapy. All patients underwent neurologic and ophthalmic assessment to rule out ocular causes of blepharospasm. Thirty-six patients were given a trial of various medications. Only one patient was successfully treated: her condition was markedly improved with pimozide after benztropine mesylate, clonazepam and amantadine hydrochloride had failed to help. Patients who did not respond to drug therapy were offered the option of undergoing eyebrow-eyelid muscle stripping surgery. The six patients who underwent surgery showed considerable improvement; however, side effects such as frontal anesthesia, exposure keratitis, lagophthalmus, scarring and eyelid malposition occurred, and three of the six had residual spasm. At this point type A botulinum toxin became available. A total of 27 patients (26 who did not respond to drug therapy, including the 3 with residual spasm after surgery, and 1 previously untreated patient) received type A botulinum toxin injections. Most experienced rapid relief from their spasms. The beneficial effects lasted weeks to months, and there were no major side effects. Treatment with type A botulinum toxin appears to be a safe and effective means of temporarily relieving blepharospasm. The long-term results with repeated injections are yet to be determined.
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PMID:Treatment of blepharospasm with medication, surgery and type A botulinum toxin. 381 52

A review of current literary sources disclosed a host of adverse reactions which may potentially be associated with the topical administration of timolol maleate. Systemic complications included a variety of cardiovascular, respiratory, central nervous system, gastrointestinal, and dermatologic reactions. Numerous ocular side effects were also reported including superficial punctate keratitis, ocular pain or discomfort, corneal anesthesia, and vague visual disturbances.
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PMID:Potential systemic and ocular side effects associated with topical administration of timolol maleate. 398 Sep 2

Mucinlike glycoprotein from tears and conjunctival goblet cell densities were determined in normal subjects and in patients. The results indicated that although there was a statistically significant decrease, a substantial amount of mucinlike glycoprotein was present in tears from patients with ocular cicatricial pemphigoid (OCP), radiation keratitis, and corneal anesthesia. In the same patients, the goblet cell count was profoundly decreased in OCP and radiation keratitis, well out of proportion to the modest fall in mucinlike glycoprotein. This indicated that the tear mucin content shows minimal variation over a great variation in goblet cell density, suggesting that while moderate mucin deficiency may be associated with surface abnormalities, such mucin deficiency may not be the only cause of the ocular surface epithelial problems characteristic of these diseases. In addition, it is proposed that the goblet cell content of the conjunctiva is a sensitive indicator of primary ocular surface disease.
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PMID:Goblet cell density in ocular surface disease. A better indicator than tear mucin. 688 59

Forty-two patients with tic douloureux underwent posterior fossa craniectomy and microvascular decompression (MVD) or partial rhizotomy of the trigeminal nerve and were followed an average of 25 months after operation. Thirty-six patients were found to have anatomical distortions of the nerve by an artery, vein, bony prominence, or a combination of factors, and 30 patients (83%) of this groups hav remained pain-free postoperatively. Six patients had no discernible pathological condition at the time of operation and underwent partial trigeminal rhizotomy. No patient underwent repeated MVD or rhizotomy, although 4 patients whose pain recurred after MVD underwent rhizotomy at a second operation. Eight of the 10 patients treated by rhizotomy are currently pain-free. The overall success rate of the entire group is 90%; 2% experienced a complication, and there was 1 perioperative death. Seventy-eight patients with tic douloureux who underwent 92 percutaneous radiofrequency trigeminal gangliolysis (PRTG) procedures were evaluated on average of 56 months postoperatively. Sixty-eight per cent of these patients when evaluated 1 year postoperatively were pain-free. However, only 35% of the PRTG procedures resulted in continued pain relief 5 years after operation. Twelve of the 78 patients (15%) required repeat gangliolysis because of recurrent tic pain. Considering all 78 patients treated with 92 PRTG procedures, 64% were pain-free at follow-up examination. PRTG was associated wtih an 8% risk of complications, which included anesthesia dolorosa, corneal anesthesia with keratitis, and significant facial paresthesias. Both PRTG and MVD have advantages. MVD should be considered because: (a) it attacks what is believed to be the primary etiology of tic douloureux, (b) the trigeminal nerve is preserved, (c) postoperative pain relief dose not depend upon the production of sensory deficit, and (d) it may have a greater potential for producing long-lasting pain relief. However, PRTG has other advantages: (a) it avoids the risks of craniectomy, (b) it is repeated easily if tic pain recurs, (c) morbidity is minimal and there is essentially no risk of mortality, and (d) it is much less expensive.
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PMID:Comparison of percutaneous radiofrequency gangliolysis and microvascular decompression for the surgical management of tic douloureux. 726 8


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