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

Because of the continued popularity of contact lenses in the United States, ocular inflammatory diseases are being encountered with increasing frequency by both ophthalmologists and primary care physicians. Distinction between minor noninfectious inflammation and serious, sight-threatening infection is crucial to the proper management of these patients. Symptoms of infectious keratitis are pain and loss of vision. Signs include infiltration or loss of clarity of the cornea, eyelid swelling, and purulent discharge. If an infectious process is suspected, the patient should be referred to an ophthalmologist immediately. If this is not possible, the contact lens should be removed and a culture performed, if possible. Aminoglycoside antibiotic drops should be applied frequently until ophthalmologic consultation is obtained. Patients should be reminded of the need for strict adherence to disinfection techniques and avoidance of homemade saline preparations. They should also be told to discontinue use of contact lenses at the first sign of ocular irritation or inflammation and to report to their physician if inflammation persists.
Postgrad Med 1989 Sep 15
PMID:Ocular disease from wearing contact lenses. A potentially devastating complication. 278 Apr 43

Eight pseudomonal species were involved in 106 invasive infections of the eye; all were community acquired. Eighteen percent of the total and 9% of the Pseudomonas aeruginosa strains were gentamicin resistant, as defined using conventional criteria. All 10 cases of "resistant" pseudomonal (nine P. aeruginosa) keratitis responded satisfactorily to treatment with gentamicin. The resistance breakpoint (defined by safe serum levels in parenteral therapy) for most P. aeruginosa is much lower than ocular gentamicin levels achievable by optimal local application. We argue for a specific ophthalmologic definition of antibiotic resistance in infections of the cornea and external eye. MIC quantitative determinations of ocular isolates would provide more useful information to ophthalmologists than conventional qualitative disc sensitivity testing.
Cornea 1989 Sep
PMID:Gentamicin-resistant pseudomonal infection. Rationale for a redefinition of ophthalmic antimicrobial sensitivities. 278 30

KID (keratitis, ichthyosis, deafness) syndrome is a congenital ectodermal defect of unknown etiology. Although achilles tendon retraction has been seen on several occasions, no other evidence of skeletal, articular or enthesopathic processes has been described. We report a patient with KID syndrome and acroosteolytic changes on radiographs, along with clinical and radiographic evidence of Jaccoud arthropathy.
J Rheumatol 1989 Sep
PMID:Jaccoud arthropathy and acroosteolysis in KID syndrome. 281 Feb 88

A female child with congenital progressive erythrokeratodermia combined with sensory hearing loss observed through a period of 5 years is reported. She demonstrates symmetrical hyperkeratotic skin changes, verrucous plaques on her nose cheeks, ears, chin, knees, elbows, and heels. Electron microscopic studies of her skin did not reveal qualitative changes, her moderate to severe hearing impairment is of cochlear origin, moderately progressive, and particularly affecting the high frequencies. Up to now a vascularizing keratitis could not be detected. Her family history is not contributory. Twenty-eight similar cases from the literature, mainly reported as 'KID' syndrome, are reviewed. There are two familial instances. Autosomal dominant inheritance is assumed. We consider the acronymic designation 'KID' syndrome misleading, since the main features of the disorder are a progressive erythrokeratodermia, cochlear deafness, and non-obligatory vascularizing keratitis.
Int J Pediatr Otorhinolaryngol 1988 Sep
PMID:Progressive erythrokeratodermia and cochlear hearing impairment. A case report and review of the literature. 297 46

We report a study on 100 patients with severe herpetic keratitis. Overall, one in three of the study group required a penetrating keratoplasty (PK). These patients required a mean of 18 days as an inpatient and 15 outpatient visits in the year the PK was performed; these figures fell to 1 inpatient day and 8 outpatient visits in the second year after surgery. The financial cost of such therapy is discussed.
J R Soc Med 1988 Sep
PMID:Severe herpetic keratitis. II. The costs associated with penetrating keratoplasty. 305 6

A retrospective review of 68 consecutive episodes of microbial keratitis complicating 66 penetrating keratoplasties (PKs) showed major risk associations: suture-related problems (50%), contact lens wear (26%), previous herpes simplex infection (15%), graft failure (15%), and persistent epithelial defects (15%). Topical steroid (85%) and antibiotic (59%) usage were common iatrogenic factors. Half the infections occurred more than 1 year after grafting. Bacterial infections involving gram-positive organisms (59%) predominated, except for patients with extended-wear hydrophilic contact lenses, which usually involved gram-negative bacilli. The incidence of fungal infections (6%) was relatively low. Recommendations to minimize microbial keratitis include prompt attention to exposed, broken, or loose sutures, and preventive and therapeutic management of epithelial defects. The inadequacy of low-dose antibiotics in precluding microbial infection in many cases and the propensity to develop infections with resistant organisms suggest that guidelines for using postoperative and prophylactic topical antibiotics require reevaluation.
Ophthalmology 1988 Sep
PMID:Microbial keratitis complicating penetrating keratoplasty. 306 38

We used an animal model of Pseudomonas keratitis to compare treatment by topical tobramycin with and without the presence of a commercially available collagen corneal shield. Pilot studies showed a significant, 30-fold increase in penetration of tobramycin into the anterior chamber in eyes with a collagen shield in place. Twenty albino rabbit eyes were inoculated with P. aeruginosa to produce stromal keratitis. After 12 hours of topical tobramycin dosing, eyes with a collagen corneal shield in place had a statistically significant (P less than .01) decrease in colony forming unit counts in comparison to treated eyes without a shield and control eyes.
Am J Ophthalmol 1988 Sep 15
PMID:Use of collagen corneal shields in the treatment of bacterial keratitis. 313 12

Collagen shields made of porcine collagen were placed in a solution containing tobramycin sulfate (40 or 200 mg/ml) for five minutes, then applied to rabbit eyes. One, four, or eight hours after application, the corneas, aqueous humor samples, and shields were assayed for antibiotic. At all intervals, the concentration of antibiotic in the corneas and aqueous humor samples exceeded the mean inhibitory concentration for tobramycin, as determined for most strains of Pseudomonas. Shields immersed in 200 mg/ml tobramycin produced significantly higher concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .0001). Shields immersed in 40 mg/ml tobramycin produced higher, although not significantly higher, concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .318). Shields immersed in commercially available tobramycin drops or injectable tobramycin solution (40 mg/ml) caused no epithelial damage visible by slitlamp examination. Collagen shields containing antibiotics can serve as a vehicle for drug delivery and may prove superior to current methods for preoperative and postoperative antibiotic prophylaxis and the initial treatment of bacterial keratitis.
J Cataract Refract Surg 1988 Sep
PMID:Collagen shield drug delivery: therapeutic concentrations of tobramycin in the rabbit cornea and aqueous humor. 318 30

Results are presented for five villages in the forest zone of Sierra Leone in which forest onchocerciasis was considered to be a significant health problem. All five villages were found to be hyperendemic and 85% (682/803) of persons were found to have at least one sign of onchocerciasis. The emergence of microfilariae from skin snips (iliac crest and/or canthus) or the presence of nodules accounted for 96.5% of all persons positive for onchocerciasis. The prevalence of nodules from all body sites was 70.5% and of elephantiasis, hanging groin and skin lesions (moderate and severe) was 0.4%, 0.3% and 5.3% respectively. Analysis of eye lesions (the most serious clinical manifestation of the disease) was restricted to persons aged 30 years and over since this gives a better indication of the public health importance of onchocerciasis than analysis in the overall population. This gave prevalence rates of onchocercal blindness of 4.5% (both eyes) and 2.8% (one eye only). Rates for the four potentially blinding eye lesions were sclerosing keratitis (4.1%), iritis (16.5%), optic atrophy (13.8%) and choroidoretinitis (14.4%). Rates in males were approximately twice as high as those in females.
Trop Med Parasitol 1988 Sep
PMID:Epidemiological studies of onchocerciasis in forest villages of Sierra Leone. 319 71

The overall prevalence of onchocerciasis was 78% and 73% in three villages of the woodland savanna of Koinadugu and four villages of the savanna-forest mosaic of Kambia respectively. The total number of persons examined was 611. In Koinadugu the prevalence of microfilariae of Onchocerca volvulus in skin snips from the iliac crest and canthus was 51.3% and 22.5% respectively while corresponding figures for Kambia were 52.2% and 19.3%. The pattern of clinical manifestations were similar in both districts, the overall rates for nodules, skin lesions (moderate and severe) and leg elephantiasis being 53.2%, 12.5% and 0.3% respectively. No cases of hanging groin were seen. The prevalence of onchocercal eye lesions was lower in the present surveys than in our own findings in Guinea or the findings of other investigators in the Guinea or Sudan savanna of West Africa. In the present study prevalences of the fourmain blinding eye lesions in persons aged 30 years or more were sclerosing keratitis (3.7%), iritis (8.7%), optic atrophy (14.2%) and choroidoretinitis (11.3%), and the prevalence of blindness was 4.2% (both eyes) and 2.0% (one eye). Males were more commonly affected than females. Further entomological studies are needed to elucidate the relative role played by the different cytospecies of Simulium damnosum s.l. in the transmission of onchocerciasis in the savanna of Sierra Leone.
Trop Med Parasitol 1988 Sep
PMID:Epidemiological studies of onchocerciasis in savanna villages of Sierra Leone. 319 72


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