Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Herpetic uveitis in man is generally, although not always, a complication of chronic stromal disease of the cornea. It is characterized by pain, photophobia, and redness, and may be abrupt in onset, particularly in recurrent cases. It is often accompanied by a severe secondary glaucoma. Various theories of the pathogenesis are discussed. The weight of experimental evidence favors the proliferation of living virus in the uveal tissues as the cause of the inflammation, although the virus has been isolated only rarely from aspirated aqueous humor. Autoimmune factors must be considered. Cyclopegia is the most important element of treatment, most cases being self-limited and non-destructive. Secondary glaucoma sometimes poses a serious problem that must be treated by radical measures. Antiviral medications such as adenine arabinoside may play an important role in the treatment of resistant cases. Corticosteroid therapy is to be avoided, if possible.
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PMID:Recurrent herpes simplex uveitis in humans. 18 36

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

We followed 210 cases of juvenile rheumatoid arthritis closely for eleven years. Thirty-six of the 210 patients (17.2%) developed iridocyclitis. Iridocyclitis was seen most frequently in young female patients (0 to 4 years) with the monoarticular or pauciatricular form of the arthritis. However, 30% of the patients developed uveitis after 16 years of age. Although 61% of patients had a noncontributory ocular history on entry, 42% had active uveitis on entry. Our approach was effective in detecting uveitis in new cases and exacerbations of uveitis in established cases. Forty-four percent of patients with uveitis had one or more identifiable signs or symptoms, such as red eye, ocular pain, decreased visual acuity, or photophobia, in order of decreasing frequency. Even after early detection and prompt treatment, 41% of cases of uveitis did not respond to more than six months of intensive topical treatment with corticosteroids and mydriatics. Despite this, there was a dramatic decrease in the 50% incidence of blinding complications of uveitis cited in earlier studies. Cataract and band keratopathy occurred in only 22 and 13% of our group, respectively. We used chloroquine or hydroxychloroquine in 173 of 210 cases and found only one case of chorioretinopathy attributable to these drugs. Systemically administered corticosteroids were used in 75 of 210 cases; a significant number of posterior subcapsular cataracts was found. Typical keratoconjunctivitis sicca developed in three of the uveitis cases. This association with uveitis and JRA was not noted previously. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.
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PMID:Ocular manifestations of juvenile rheumatoid arthritis. 107 93

A series of 30 enucleated eyes, all of which had a primary histological diagnosis of scleritis, was analysed. The average age of patients at enucleation was 68 years; many of these patients had had the disease for more than 30 years. In 40 per cent the diagnosis of scleritis was unsuspected and was often masked by multiple complications. Scleritis with uveitis and glaucoma was the most common combination to come to enucleation. In 82 per cent, pain was the reason for enucleation, which suggests that some patients were on inadequate levels of steroid treatment or were unable to tolerate them. In the series, 37 per cent of the eyes perforated. Perforation occurred in those patients who were having steriods but not in those who were not, but the data are inconclusive as to which method of steroid administration was most likely to cause ocular perforation.
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PMID:Evaluation of eyes enucleated for scleritis. 126 81

A consecutive series of 38 eyes of 35 glaucoma patients treated with transillumination guided cyclocryotherapy (CCT) either to obtain pain relief or to achieve IOP control was studied at Helsinki University Eye Hospital. Transillumination was used to guide the applications to the correct site. The follow-up range was 1-43 months (mean 9 months). Pretreatment IOP was 39 +/- 13 mm Hg and postoperative 26 +/- 16 mm Hg (mean +/- SD). Twenty-three eyes underwent one and 15 eyes 2-5 procedures. IOP control (IOP 9-23 mm Hg) was achieved in 50%. The response was more favorable in eyes without iris neovascularisation (59% achieved IOP control) than in eyes with neovascular glaucoma (38% achieved IOP control). The best response was achieved in eyes with chronic uveitis (5/7 eyes achieved IOP control). Repeated procedures improved the IOP control rate. Hypotony (IOP < 9 mm Hg) without clinical signs of phthisis occurred in three eyes (8%). Thirteen eyes needed primarily pain relief and 92% achieved it. Postoperatively vision was better in 8%, unchanged in 37% and worse in 55%. Visual acuity was 0.05 or better in nine eyes pretreatment and in eight eyes after treatment.
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PMID:Transillumination guided cyclocryotherapy in the treatment of secondary glaucoma. 128 52

We studied 39 blind painful eyes in 39 patients who were treated with retrobulbar injection of absolute (96%) alcohol for their severe ocular pain at the King Khaled Eye Specialist Hospital from January 1984 to January 1987. There were 21 (54%) male and 18 (46%) female patients; all were followed for at least three months. The protracted ocular pain was mainly due to: end-stage (absolute) glaucoma in 31 (80%) eyes, uveitis or endophthalmitis in four (10%) eyes, or corneal ulcer in two (5%) eyes. One eye had painful phthisis bulbi, and one eye had infraorbital neuralgia. The complications encountered were transient and included blepharoptosis in eight (21%) eyes, external ophthalmoplegia, and corneal epithelial defect. The effective time of the injection to relieve pain ranged from two weeks to two years (mean, 29 weeks). The authors believe that there is still a place for retrobulbar alcohol injection for blind painful eyes when enucleation or evisceration is not possible.
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PMID:Retrobulbar alcohol injection in blind painful eyes. 170 80

We used the semiconductor diode laser to perform transscleral cyclophotocoagulation in 14 patients with glaucoma. Laser settings used for this procedure were 990 milliseconds, 100-microns spot size, and 1,200 mW of power. Applications were placed 1 mm posterior to the surgical corneoscleral limbus and 1 mm defocused toward the ciliary body. The mean preoperative intraocular pressure was 34.8 +/- 13 mm Hg, and the mean intraocular pressure six months after a single treatment session was 24.3 +/- 18 mm Hg (P greater than .001, paired t-test). The mean number of glaucoma medications decreased from 2.2 preoperatively to 1.4 postoperatively. Complications included conjunctival burns and uveitis in 14 patients, and pain in one patient. These results suggested that semiconductor diode transscleral cyclophotocoagulation may be useful as a treatment to reduce the intraocular pressure in patients with glaucoma.
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PMID:Semiconductor diode laser transscleral cyclophotocoagulation in patients with glaucoma. 172 52

We reviewed the medical records of 97 patients who had 101 consecutive intraocular lens (IOL) explantation procedures, with or without exchange, at the University of Florida Eye Center from January 1, 1983, to December 31, 1987. The majority of the removed IOLs were anterior chamber styles (53.9%), followed by iris-fixated lenses (33.7%). The most common indications for surgery included pseudophakic bullous keratopathy (PBK)--69%, uveitis-glaucoma-hyphema (UGH) syndrome--9%, and IOL instability--7%. The best visual outcome was seen in patients with IOL instability; 50% achieved 20/40 or better visual acuity. Forty one percent of patients with PBK, who had IOL explantation/exchange combined with penetrating keratoplasty, achieved 20/40 or better visual acuity. The poorest visual outcome was seen in patients with the UGH syndrome; 83% had a final acuity of 20/200 or worse. However, these patients achieved resolution of their pain and inflammation and better control of their intraocular pressure as a result of the surgery. Complications leading to IOL explantation tended to occur months to years after the original surgery in patients with closed-loop, semi-flexible anterior chamber lenses and iris-fixated lenses. Posterior chamber lenses were most often removed because of complications unrelated to the implant.
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PMID:Indications for and results of intraocular lens explantation. 173 66

Fuchs' heterochromic cyclitis (FHC) is an important diagnosis to make. Not only for the patient, because incorrect diagnosis may lead to unnecessary therapy and the failure to detect secondary glaucoma, but also for the comparison of studies on the etiology of FHC, which is still unknown. No clinical criteria for establishing the diagnosis of FHC have been internationally accepted yet. By means of clinical analyses of FHC patients in different parts of the world, predominant clinical features may be distinguished and combined to form (internationally accepted) diagnostic criteria. We report a clinical analysis of 51 FHC patients in the Netherlands. Acute symptoms (severe redness, pain or photophobia) were never (100%) encountered. Characteristic keratic precipitates (88%) and/or minimal aqueous cells and flare (60%) and/or vitreous opacities (84%) were major signs, indicating a chronic inflammatory activity, in which no synechiae (100%) were present. Heterochromia (82%) was not a constant sign, but iris stromal atrophy, which causes the heterochromia, was always present (100%). Cataract was present in 82% as a result of the chronic iridocyclitis. Secondary glaucoma was present in 22%. Based on the predominant clinical findings obtained from this analysis of FHC patients, and on data in the literature, we propose clinical diagnostic criteria for FHC. Future studies, also including other uveitis groups, are necessary to confirm these diagnostic criteria.
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PMID:Clinical analysis of Fuchs' heterochromic cyclitis. 179 Jul 45

The use of intra-articular steroids in one or both knees was evaluated in 21 children with type 1 pauciarticular juvenile chronic arthritis (JCA). The beneficial effect of the injection was noted within 3 days with no significant adverse reactions. Remission exceeding 6 months was seen in 70% of the knees and the arthritis remained inactive during the follow up period in 37%. The beneficial effect of the injection did not correlate with sex, age of onset or the presence of antinuclear antibodies or HLA-B27 antigen and there was no relationship with the size of involved joints at onset, the ESR at onset, or the presence of uveitis. Intra-articular corticosteroids in this type of JCA may provide prompt relief of swelling and pain and reduce the need for other forms of therapy. Remission was long lasting in the majority of the children.
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PMID:Intra-articular steroids in pauciarticular juvenile chronic arthritis, type 1. 204 86


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