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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

A pilot study of the possible anticholinergic side effects of femoxetine comprised eight depressive patients (age 42-65), followed up for a month, and five healthy volunteers (age 26-39), who received medication for a week. As judged primarily from ophthalmic parameters (accomodation, lacrimation, pupil size, intraocular pressure, exe motility, visual acuity and visual fields, slit lamp examination and ophthalmoscopy), there was no indication of anticholinergic side effects of the drug. According to Schirmer-1-test (tear wetting), the rather dry eyes of depressive patients even improved somewhat during medication.
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PMID:Femoxetine and eye function. A study of possible anticholinergic side effects. 401 71

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

HRT (Hormone Replacement Therapy) is the administration of low estrogen preparation to post-menopausal women. This therapy is considered to be effective in protecting various human tissues from aging processes, which are also related to the decrease in endogenous estrogen level. Estrogen receptors were found in many human tissues and organs, including the eye. Therefore HRT may also have a beneficial effect on the eye and its adnexa. This review presents the ever growing data accumulated over the past years concerning the beneficial effects of HRT on various eye pathologies. It was found that HRT may relieve dry eye symptoms in post-menopausal women, may decrease the intraocular pressure and may delay cataract formation in treated women. In the retina, HRT may play a role in decreasing the incidence of Aging Macular Degeneration (AMD) in post-menopausal women.
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PMID:[The effects of hormone replacement therapy (HRT) on the human eye]. 1194 25

While the short- and medium-term refractive and acuity results of excimer laser refractive surgery may now be generally satisfactory, the relatively brief history of the procedures involved (around 10 years or less) means that those concerned with eye care must remain vigilant to the possibility of longer-term problems. This paper reviews some relevant studies of potential post-surgical effects, including imperfect corneal healing and recovery of innervation, reduced corneal sensitivity and dry eye problems, changes in corneal rigidity leading to slow refractive change, possibly misleading reductions in measured intraocular pressure, and retinal and vitreous pathology.
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PMID:Some possible longer-term ocular changes following excimer laser refractive surgery. 1216 78

Glaucoma is a pathological condition whose most important risk factor is increased intraocular pressure (IOP). The medical treatment of glaucoma essentially consists of compounds that are able to decrease the IOP. The compounds discussed in this review act in a different way, beta-blockers mainly inhibit the production of aqueous humor, whereas latanoprost decreases the resistance in the outflow channels. beta-Blockers are compounds with a well-known efficacy and safety profile and they are fairly inexpensive. Their systemic and local side effects are mainly cardiovascular and pulmonary adverse events, dry eye and keratopathy. Latanoprost, which has recently been introduced into the market, has been shown to be equally as effective, or better in lowering IOP in patients than timolol, although it is more expensive. Systemic reported side effects are anecdotal; local hyperaemia, keratopathy, hypertrichosis, increased pigmentation of eyelashes and iris, uveitis and cystoid macular oedema have been reported. A comparison of costs reveals that a 1-year therapy with timolol ophthalmic solution starts from 11.00 Euros and can reach 146.00 Euros for the most expensive preservative-free 1-day dispenser packages (approximately 13.5 times higher). For latanoprost once-daily administration, the cost for 1 years therapy is 98.55 Euros, approximately six times higher than generic or brand 0.5% timolol applied twice-daily. What are the factors influencing a change in therapy from beta-blockers to latanoprost? The only good reason is represented by a further deterioration in the visual field. This may occur, despite a significant reduction in IOP, because the reached IOP is not sufficient enough to avoid further deterioration because the patient's work or social activities do not allow a correct daily dosage of the compound (bad compliance); or as a result of treatment suspension, because of the development of systemic and/or local side effects. Changes in therapy must always be related to a failing control of the disease, as any therapeutic modification leading to an increase in the number of visits and additional examinations, consequently enhances the costs.
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PMID:Assessing the cost-effectiveness of switching from a beta-blocker to latanoprost in the treatment of ocular hypertension. 1452 87

Ocular inflammatory diseases impose a significant medical and economic burden on society. Corticosteroids are potent anti-inflammatory agents that have been used successfully to treat ocular inflammation. Topical corticosteroids provide maximal drug delivery, and are used to reduce the signs and symptoms of intraocular and ocular surface inflammation. However, side effects associated with topical corticosteroids-including increased intraocular pressure, risk of cataract formation after long-term use, and decreased resistance to infection-are concerns. Loteprednol etabonate (LE) is an ester corticosteroid with a high therapeutic index that contains an ester, rather than a ketone, at carbon-20 of the prednisolone core structure. LE blocks the release and action of inflammatory mediators and is clinically effective in the treatment of steroid-responsive inflammatory conditions including giant papillary conjunctivitis, seasonal (intermittent) allergic conjunctivitis and uveitis. LE relieves ocular surface and lacrimal gland inflammation associated with dry eye and is used in combination with ciclosporin A as a treatment of dry eye. LE is also effective in the treatment of postoperative ocular inflammation. Because of its rapid de-esterification to inactive metabolites, LE appears to have an improved safety profile compared with ketone corticosteroids, and may be more suitable than ketone corticosteroids for the treatment for ocular inflammatory conditions in which long-term therapy is necessary. However, further comparative safety studies are needed.
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PMID:Treatment of ocular inflammatory conditions with loteprednol etabonate. 1824 74

Glaucoma affects an increasing number of people worldwide and is the second leading cause of blindness. The aim of antiglaucoma therapy is to maintain a patient's visual function and quality of life. Prostaglandin analogues are first-line topical antiglaucoma therapy. They are effective at lowering intraocular pressure (IOP) and are generally well tolerated, with fewer systemic adverse events compared with the other classes. However, the use of prostaglandin analogues can be associated with ocular adverse effects, such as stinging/burning sensation, dry eyes, iris and periocular hyperpigmentation, and eye lash growth, which can affect patient compliance. Preservatives used in antiglaucoma preparations can have dose-dependent toxic effects, which contribute to adverse effects. The development of preservative-free preparations may reduce such adverse effects and therefore improve patient compliance. Tafluprost is a prostaglandin analogue in a preservative-free formulation that was recently approved for the reduction of elevated IOP in open-angle glaucoma and ocular hypertension.
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PMID:A review of preserved and preservative-free prostaglandin analogues for the treatment of open-angle glaucoma and ocular hypertension. 2057 9

New diagnostic instruments for imaging the anterior segment of the eye have been developed using the corneal topographer, wavefront sensor, and anterior segment optical coherence tomography (OCT). Data obtained from these instruments can be used to choose treatment modalities by providing information that is complementary to slit-lamp examination and visual acuity measurements. Zernike vector analysis was used to evaluate the corneal higher-order aberrations to quantify the effects of the corneal shape on the optical quality of the eye. The analyses showed the optical characteristics of the anterior and posterior surfaces of the cornea in patients with keratoconus or pellucid marginal corneal degeneration. The association between the deterioration of optical quality during rigid gas-permeable contact lens wear in patients with keratoconus and the residual coma due to posterior corneal shape was suggested by the findings made with this method. Zernike vector analyses also revealed the differences in the ocular higher-order aberrations between conventional Laser in situ keratomileusis (LASIK) and custom LASIK. Serial measurements of the ocular higher-order aberrations by a wavefront sensor enabled us to evaluate the effects of tear fluid dynamics on the optical quality of the eye. The findings clarified the characteristics of serial alterations of higher-order aberrations in normal eyes, dry eye with tear deficiency and dry eye with tear evaporation. The effects of internal lubricating agents on the soft contact lenses were also evaluated objectively. In addition, these results suggest that the effects of serial fluctuations in the ocular higher-order aberrations on refractive surgery should be considered. To observe the cornea at the cellular level with anterior segment OCT, a prototype machine of full-field OCT was developed. This made it possible to show epithelial edema in human donor corneas as well as the alterations in the epithelial layer and stromal layer associated with intraocular pressure elevation in ex vivo porcine eyes. An OCT-based corneal topographer was developed using a three-dimensional anterior segment OCT with the swept-source principle. Corneal topographic analyses of the anterior and posterior surfaces either in eyes with keratoconus or following keratoplasty was possible even in where it was difficult for conventional corneal topographers to analyze accurately. Also, OCT-based corneal topographer analyzed the host and donor cornea separately following Descemet stripping automated endothelial keratoplasty by recognizing the host-graft interface. The results from these new diagnostic methods for imaging the anterior segment of eye will be useful for the diagnosis of corneal disorders and the planning of treatment by evaluating the effects of corneal topographic abnormalities and tear fluid dynamics on visual function, by observing the abnormalities of the corneal tissue at the cellular level, and by showing corneal topography in diseased corneas more accurately and non-invasively.
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PMID:[New diagnostic methods for imaging the anterior segment of the eye to enable treatment modalities selection]. 2147 12

To determine and analyze the reasons for patients not undergoing laser corneal refractive surgery. A retrospective observational study was conducted to analyze the reasons for not undergoing laser corneal refractive surgery in 611 patients. In this study, 611 (14.34%) among 4,262 enrolled patients did not undergo laser corneal refractive surgery. Among these 611 patients, the common reasons for not undergoing laser corneal refractive surgery were concern about the surgery (366 patients, 59.90%), insufficient corneal thickness (72 patients, 11.78%), too high corneal refractive power (36 patients, 5.89%), dry eye (33 patients, 5.40%), high intraocular pressure (22 patients, 3.60%), poor corrected visual acuity (25 patients, 4.09%), retinal diseases (23 patients, 3.76%) and others (34 patients, 5.56%). The concern about surgery is the primary factor for the patients not undergoing laser corneal refractive surgery.
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PMID:Analysis of the reasons for not undergoing laser corneal refractive surgery in 611 patients. 2175 Oct 67


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