Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An outbreak of acute haemorrhagic conjunctivitis (AHC) occurred in Accra, Ghana, reaching a peak in July 1987. Individuals ranging from infants to adults over 50 years were infected, with those between 20 and 30 years being the most affected group. There was a female preponderance. Clinical features included conjunctivitis, subconjunctival haemorrhage and ocular pain. Some patients reported of blurred vision due to mild keratitis. Isolation of virus from clinical specimens of AHC patients was successful only in cells of human origin such as HeLa and FL. Coxsackie virus A24 variant (CA 24v) was identified as the aetiologic agent. This is the first report to associate CA 24v with an epidemic of AHC in Africa, south of the Sahara, which is outside the endemic area of Southeast Asia and the Caribbeans. This finding suggests that earlier outbreaks of AHC in Ghana and Africa may have been due to CA 24v but went undetected. The results of various tests performed during this study suggest that, at least, two antigenically different viruses of CA 24v circulated during the course of this epidemic.
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PMID:Epidemic acute haemorrhagic conjunctivitis due to Coxsackie virus A24 variant in Ghana. 196 35

The epidemiological and clinical features of primary herpes simplex virus ocular infection in 108 patients were studied. Of these, 69 (64%) were aged 15 or over and only eight (7%) were under the age of 5. Associated upper respiratory tract infection was found in 38 (35%) patients and systemic disorders such as mild malaise, fever, and aching in 34 (31%) patients. Common symptoms were redness, watering, discharge, itching, irritation, and lid swelling, whereas pain, photophobia, lid vesicles and ulcers, and blurred vision were less frequent. The major signs consisted of vesicles and ulcers on the lids, papillary responses which were more severe in the upper lid conjunctiva, follicles which were more common in the lower lid conjunctiva, fine and coarse epithelial punctate keratitis, and subepithelial punctate keratitis. Dendritic ulcers and disciform keratitis were found in 16 (15%) and two (2%) patients respectively. The clinical forms of primary herpes simplex virus ocular infection varied. Moderate or severe disease was observed in 41 (38%) and 16 (15%) patients respectively. In eight (7%) patients the disease presented as an acute follicular conjunctivitis without characteristic lid or corneal lesions. A chronic blepharoconjunctivitis which lasted for months developed in 16 (15%) patients. The epidemiological and clinical features in our patients were compared with features of the disease reported previously.
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PMID:Epidemiological and clinical features of primary herpes simplex virus ocular infection. 396 25

In a retrospective survey of patients taking medication for hyperlipidaemia, those taking niacin (nicotinic acid) were more likely (p < 0.05) to report sicca syndromes, blurred vision, eyelid oedema, and macular oedema compared with those who never took niacin. Additionally, 7% of those taking niacin discontinued the drug owing to adverse ocular side effects, while none of the other lipid lowering agents were found to cause these side effects (p = 0.016). Data from spontaneous reporting systems support a possible association of decreased vision, cystoid macular oedema, sicca-like symptoms, discoloration of the eyelids with or without periorbital or eyelid oedema, proptosis, loss of eyebrow or eyelashes, and superficial punctate keratitis with the use of niacin in high doses. Decreased vision may be marked, and if the drug is not discontinued, may progress to cystoid macular oedema. All ocular side effects listed above are reversible if the association with niacin is recognised and the drug is discontinued; both the incidence and severity of the ocular side effects seem to be dose dependent.
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PMID:Adverse ocular effects associated with niacin therapy. 788 Jul 95

Botulinum toxin has become the initial treatment of choice for the management of essential blepharospasm, hemifacial spasm and other craniocervical dystonias. Numerous studies have confirmed a 90% to 95% response rate. Although a number of common side effects have been reported, the occurrence and incidence of rare local complications remains poorly understood. More importantly, the acute and chronic distant effects of botulinum toxin have not been clearly elucidated. A better understanding of such effects is essential if clinicians are to appropriately advise patients on the use of this therapeutic modality. This article is based on the Duke University experience in the management of over 500 patients with craniocervical spasm disorders, combined with a review of the published literature. These disorders include essential blepharospasm, oromandibular dystonia, hemifacial spasm, and torticollis. The incidence of side effects following more than 6000 treatments with botulinum toxin is presented. Pertinent research relating to the causes of these complications is also reviewed. The most common complications of treatment with botulinum toxin are related to acute local effects resulting from chemodenervation. The most important clinical effect in this group is weakening of the levator muscle resulting in ptosis, and the corneal consequences of lagophthalmos. The latter includes exposure keratitis, dry eyes, blurred vision, and hypersecretion epiphora. Less common local effects include facial numbness, diplopia, and ectropion. Some distant effects are being observed with increasing frequency. These include pruritus, dysphagia, nausea, and a flu-like syndrome. Most significant, however, are the rare reports of generalized weakness and the documentation of EMG abnormalities distant to the site of toxin injection. This has been seen with injections for both blepharospasm and torticollis. Until further studies on the long-term distant complications of botulinum toxin are available, it is recommended that patients receive as few life-time doses of toxin as possible, consistent with adequate management of their spasms. The practice of reinjecting patients routinely every three months, or at the first return of mild spasms should be discouraged.
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PMID:Botulinum-A toxin in the treatment of craniocervical muscle spasms: short- and long-term, local and systemic effects. 882 30

We report a patient who developed keratitis and corneal edema during treatment with carbidopa-levodopa. The patient was a 34-year-old woman who complained of apraxic gait after anoxic brain damage caused by ventricular arrhythmia. She had difficulty in walking. While doses of droxidopa, flecainide acetate and amantadine HCl were kept at the same levels as before several weeks, administration of carbidopa-levodopa was gradually increased from an initial dose of 100 mg per day to 300 mg per day over a period of 10 days in an attempt to relieve her apraxic gait. Ten days after initiation of treatment with carbidopa-levodopa, her postural instability and unsteady gait slightly improved. However, after 8 days of treatment with carbidopa-levodopa, she complained of blurred vision. Ophthalmologic examination showed keratitis (corneal endothelitis) and corneal edema. After stopping carbidopa-levodopa, the keratitis dramatically improved. Cessation of the drug therapy resulted in a return of vision to normal levels by the 7th day. Although there had been no previous reports of corneal lesion caused by levodopa, we suspected that keratitis and corneal edema were associated with carbidopa-levodopa use, especially in combination treatment with flecainide acetate, and amantadine HCl. The process was reversible and presumably could have been prevented by a shorter term of medication.
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PMID:[Keratitis and corneal edema associated with levodopa use--a case report]. 895 58

We report the frequency and type of infectious ocular complications following orthotopic liver transplantation (OLT) and review diagnostic and therapeutic strategies. During the period September 1988 through November 1994, 684 patients underwent OLT at Mount Sinai Hospital (New York). Nine orthotopic liver transplant patients (1.3%) developed ocular infections: Candida albicans endophthalmitis (2), Aspergillus fumigatus endophthalmitis (1), cytomegalovirus retinitis (4), herpes simplex virus keratitis (1), and varicella-zoster virus panophthalmitis (1). The mean time from OLT to ocular symptoms was 42 days for patients with fungal infections and 128 days for patients with viral infections. Blurred vision was the commonest symptom (five of nine cases). The mean duration of follow-up was 2 years (range, 33 days to 5 years). Permanent loss of vision occurred in three patients, five had improvement in visual acuity, and one died of disseminated aspergillosis 33 days after OLT. Infectious ocular complications following OLT may occur as isolated events or with disseminated disease. Fungal infections occur earlier (mean, 42 days after OLT) than viral infections (mean, 4 months after OLT). The clinical presentation may be atypical; aggressive vitreoretinal procedures and serial examinations may be required to establish the diagnosis. Cytomegalovirus retinitis in orthotopic liver transplant patients may not require life-long maintenance therapy with antiviral agents.
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PMID:Infectious ocular complications in orthotopic liver transplant patients. 919 78

A 39-year-old woman had laser in situ keratomileusis that was complicated by intraoperative epithelial erosion in both eyes. Seven months after surgery, the patient returned, complaining of pain and blurred vision in the left eye. Slitlamp examination revealed corneal epithelial erosion with severe diffuse lamellar keratitis (DLK). Reepithelialization was complete in several days. However, severe inflammation remained until systemic steroids were administered. Recurrent erosions can lead to a serious inflammatory reaction such as DLK because of the presence of the flap-stroma interface.
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PMID:Severe late-onset recurrent epithelial erosion with diffuse lamellar keratitis after laser in situ keratomileusis. 1460 29

A 32-year-old man had photophobia and blurred vision 2 weeks after uneventful laser in situ keratomileusis to correct myopia. He was treated with steroids for suspected diffuse lamellar keratitis, antiherpetics, and antibiotic eyedrops, but the condition worsened and the patient developed further blurred vision, an inflamed eye, and pain. When referred to us, the patient had an extensive corneal ulcer with hypopyon and mycelia were reported in scrapings of the ulcer bed. Nattrassia mangiferae (Hendersonula toruloidea) was cultured from the specimen. The patient was treated with antifungal agents and 2 penetrating keratoplasties. At the last examination, the uncorrected visual acuity was 20/200.
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PMID:Nattrassia mangiferae keratitis after laser in situ keratomileusis. 1496 3

A 33-year-old woman had progressive blurred vision 2 weeks after uneventful laser in situ keratomileusis surgery. Initial satisfactory uncorrected visual acuity (UCVA) was complicated by postoperative dry eye and drug toxicity. Slitlamp biomicroscopy revealed diffuse punctate epithelial keratitis and inferior corneal epithelial defect with rolled-up epithelium on the flaps and the inferior unoperated cornea in both eyes. Diffuse inflammatory cell infiltrates were evident in the stroma. Stromal thinning was evident on serial Orbscan (Bausch & Lomb) and pachymetry examinations, and a hyperopic shift of almost +6 diopters was observed in the refractive error in both eyes. These examinations showed a gradual recovery of stromal thickness after copious hydration with balanced salt solution. The UCVA was 1.0 in both eyes after corneal rehydration.
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PMID:Toxic keratopathy-related corneal dehydration after laser in situ keratomileusis. 1612 7

Bee stings of the cornea are rarely reported, but have the potential for causing serious ophthalmological injuries. We present a case of corneal bee sting with retained stinger apparatus. A 35-year-old patient presented with an acute, corneal bee sting of the right eye 12 hours after he was stung. The patient suffered from pain, blurred vision, and epiphora. The right eye showed edema of the upper and lower eyelid, conjunctival hyperemia, chemosis, and striate keratitis of the paracentral cornea by biomicroscopic examination. The stinger was identified in the depth of the corneal infiltration. Visual acuity was 5/10. It was removed surgically. After 2 months, the eye only showed a minimal residual corneal opacification. Visual acuity was 10/10. We present a case of bee sting to the cornea with retained stinger apparatus and treatment of this unusual presentation.
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PMID:Bee sting of the cornea: a case study and review of the literature. 1720 May 91


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