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Query: UMLS:C0314719 (dry eye)
 2,625 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The hypotensive effect of Timolol eye drops (0.25 and 0.50%) in maintenance treatment of 64 patients with elevated intraocular pressure has been studied. The patients were treated for a period of mean 13 months. In 44 patients mostly comprising ocular hypertensives, a significant reducation in IOP (32%) could be maintained with Timolol alone (P less than 0.001). In patients with a high starting baseline pressure of previous maladjustable glaucoma it was necessary to start combined treatment. Pilocarpine, epinephrine or acetazolamide appeared to have additive pressure-lowering effect to Timolol. A significant correlation was present between pre-treatment and Timolol treated intraocular pressures. Thus a pre-treatment IOP above 25 mmHg may indicate a critically hypotensive effect below an IOP of 20 mmHg with Timolol alone. No significant interfernce with visual acuity, pupullary size, blood pressure, or pulse rate was noted. Existing visual field defects in three patients were slightly aggravated and in four patients, with a pathological optic disc, visual field loss developed. In seven patients transient sensations of dry eyes and rose-bengal staining dots on the cornea developed.
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PMID:Timolol in maintenance treatment of ocular hypertension and glaucoma. 54 4

Central corneal perforations have traditionally been managed by conjunctival flaps, tissue adhesives, soft contact lenses, corneal patches and other conservative measures for the immediate preservation of the eye. An alternative method of treatment is immediate penetrating keratoplasty. We present the result of immediate keratoplasty for 25 eyes referred with acute central corneal perforations, 20 of herpetic origin and 5 with a chemical burn or dry eye syndrome. In all cases, the eye was successfully preserved. Twelve of 20 grafts (60%) for herpetic perforation went on to eventual clear grafts as opposed to 1 of 5 grafts (20%) in the dry eye or chemically burned patients. Significant complications encountered included cataract formation, secondary glaucoma and persistent epithelial defects; however, these should not preclude eventual restoration of good visual acuity. Penetrating keratoplasty in acutely inflamed and perforated eyes used to lead to angle closure and secondary glaucoma in a considerable number of cases, sometimes progressing to total disaster. We have shown that if enough corticosteroids are given immediately postoperatively, the risk for angle closure is not significant.
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PMID:Penetrating keratoplasty in acute herpetic corneal performations. 77 41

Common ophthalmic disorders occurring in older adults often can be managed in the primary care setting with appropriate medication. This review focuses on pharmacologic intervention for dry eye, allergy, glaucoma, inflammatory disease, and infection, as well as diagnostic agents for dilation. Discussed are the selection, proper administration, dosage forms, and side effects of ophthalmic agents.
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PMID:An update on the use of drugs for common eye problems in older patients. 193 61

The ophthalmic rod (OR) is a new ophthalmic drug-delivery system. The rod is made of nontoxic plastic. The active substance is deposited as a thin film on the end of the rod. To deliver the drug, the tip of the rod is introduced into the conjunctival sac and rubbed against the palpebral conjunctiva of the lower lid. The OR is a single-dose sterile applicator. By using the OR the problems of preservation and sterility of eyedrops are eliminated, and the risk of cross-infection is avoided. This was an open uncontrolled study. Clonidine ORs were used by 15 patients with glaucoma for 12 days. Fluorescein ORs were used for tonometry and to check the safetness of using the ORs. Patients with dry eyes or scotoma were excluded from the study. The clonidine film remaining on the ORs after delivery was quantitatively analyzed. A dose of 20 micrograms clonidine rod, three ORs/day, was sufficient to keep the ocular pressure under control. The fluorescin ORs, 30 micrograms/rod, were satisfactory for coloring the cornea. On the last day (12th) no clinically apparent side effects were observed. Subjectively, the patients were satisfied with the OR method of application, as an alternative to eyedrops.
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PMID:The ophthalmic rod--a new drug-delivery system II. 220 45

Determination of tear lysozyme, alfa-1-antitrypsin and serum albumin was performed in the tear fluid of 24 glaucoma patients on maintenance treatment with timolol. In 7 patients with symptoms of dry eye decreased levels of tear lysozyme and increased levels of alfa-1-antitrypsin and serum albumin were disclosed in contrast to 17 timolol treated patients without dry eyes and to healthy controls. The timolol treated patients with ocular dryness also showed hyperosmolality of tear fluid, abnormal corneal staining with rose bengal and decreased break-up time and Schirmer-I-test. It is concluded that decreased concentration of tear lysozyme in glaucoma patients on topical treatment with timolol may indicate some impairment of the tear gland function provoked by the treatment.
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PMID:Lysozyme, alfa-1-antitrypsin and serum albumin in tear fluid of timolol treated glaucoma patients with and without symptoms of dry eyes. 697 56

A double-masked cross-over comparison of the ocular hypotensive effect in 19 glaucoma patients between timolol 0.5% - a non-selective beta-blocking agent - and metoprolol 3% - a beta 1-selective blocking agent - disclosed a greater pressure lowering effect (mean 9%, median 7% more) with timolol in a treatment period of 1 month. In patients on timolol treatment 47% - 60% of the eyes could be controlled on an IOP level less than 20 mmHg compared to 34% - 47% of the eyes treated with metoprolol. Metoprolol induced a transitory burning sensation in the eyes of 58% patients compared to 26% treated with timolol. Possible signs of dry eyes manifestations as measured by break-up time, rose bengal and fluorescein 1% staining, tear osmolality and Schirmer test I developed in both the timolol (4 patients) and metoprolol (3 patients) treated group. No significant influence on blood pressure and heart rate was observed. In none had the visual field or visual acuity deteriorated at the end of the study.
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PMID:Timolol and metoprolol in glaucoma. A comparison of the ocular hypotensive effect, local and systemic tolerance. 703 54

During the past decade 2,436 patients with primary glaucoma were treated in the Budapest Eye Clinic. Symptoms and/or signs of dry eye syndrome were seen in 108 of them, i.e., 4.43%. In 42 cases these symptoms developed during conservative glaucoma treatment. Strikingly, there were more men among these patients than in the control group of sicca patients without glaucoma and there were less patients with generalized diseases related to keratoconjunctivitis sicca in the group of glaucoma patients with dry eyes. The Schirmer test was positive in a smaller percentage and corneal staining with bengal rose was more frequent in the group of sicca patients with glaucoma than in the group of sicca patients without glaucoma. Most of the glaucoma patients with dry eyes received pilocarpine dropps. The most noteworthy electron-microscopic feature of the bulbar conjunctiva was the reduction in frequency, height and width of the microplicae on the surface of the epithelial cells. The intercellular spaces were enlarged among the superficial cells and vacuoles appeared in their cytoplasm.
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PMID:[Glaucoma and the dry eye syndrome]. 741 53

Epithelial permeability and autofluorescence of the cornea were determined by fluorophotometry in 21 patients with open-angle glaucoma or ocular hypertension using timolol medication with the preservative benzalkonium chloride (BAC) and 2 weeks after changing to timolol medication without BAC. The investigation was performed to determine whether removal of BAC would reduce toxic effects on the cornea and complaints of sensations of burning or dry eye. Corneal epithelial permeability decreased significantly after changing medication (mean decrease per patient 27%, P = 0.025). Corneal autofluorescence increased significantly after changing medication suggesting an alteration in corneal metabolism (mean increase per patient 6%, P = 0.003). Timolol without BAC was found to be as effective as timolol with BAC in reducing intraocular pressure (P = 0.4). Removal of BAC from timolol resulted in an improvement of corneal epithelial barrier function and in a reduction of complaints. The improvement was found to be proportional to the duration of the preceding BAC-containing therapy.
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PMID:Topical timolol with and without benzalkonium chloride: epithelial permeability and autofluorescence of the cornea in glaucoma. 803 10

Ophthalmic drugs, both diagnostic and therapeutic, play a central role in new developments in optometry, particularly as practitioners extend their involvement in primary care. Optometrists now dilate more patients in routine practice, and this brings increasing concern about the risk of provoking acute closed angle glaucoma (CAG) attacks. It would seem that the risk of inducing acute CAG is far outweighed by the potential benefit of examining the eye through a dilated pupil. Driving difficulties, reported subjectively to be the result of glare, are frequently encountered by patients after dilation, and advice from the College of Optometrists is welcomed. The local anaesthetic proxymetacaine 0.5% is now marketed in the UK in preservative-free unit-dose applicators both alone and in combination with fluorescein, and is a more comfortable alternative to existing anaesthetics in unit-dose form. The second half of this paper includes a summary of the background to recent developments, as the UK profession takes its first steps towards the use of ocular therapeutic agents. Finally, some exciting new therapeutic preparations for use in the treatment of glaucoma, allergic eye disease, and dry eye conditions are discussed.
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PMID:An overview of the current drugs scene. 969 28

Physical or chemical injuries, infections, immunologic oculocutaneous disorders, drugs, and various systemic disorders may cause scarring of the conjunctiva and disturbances of the ocular surface. Trichiasis, lid margin malposition, and dry eye may result in persistent ocular irritation. The cornea may be primarily or secondarily involved. If severe, disturbances of the ocular surface may lead to significant visual impairment. Thorough evaluation of patients and of the underlying disease process is required for optimal management. Treatment may be challenging and should be comprehensive, combining medical measures and surgical correction of structural changes. Suppression of exogenous irritants, treatment of dry eye, antiinflammatory therapy, and immunosuppressants are paramount to control the underlying disease and allow optimal surgical results. Surgical correction of trichiasis and lid margin malposition, conjunctival grafting, mucous membrane transplantation, limbal stem cell transplantation, amniotic membrane transplantation, and penetrating keratoplasty help reestablish a physiologic ocular surface. Severe cases may require keratoprosthetics for visual rehabilitation. Corneal ulceration or perforation requires prompt attention to maintain ocular integrity. Special measures should be considered for patients who require cataract or glaucoma surgery.
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PMID:Management of conjunctival cicatrizing diseases and severe ocular surface dysfunction. 1034 May 65


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