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Query: UMLS:C0344232 (blurred vision)
 2,072 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Keratitis is a sight-threatening inflammatory condition of the cornea that can be caused by both infectious and non-infectious agents. Physical or chemical trauma are typically related to non-infectious keratitis, which may then become secondarily infected or remain non-infected. Etiology of infectious keratitis is most often associated with bacteria; but viruses, fungi, and parasites are common causative pathogens as well. As a global concern, common risk factors include: systemic immunosuppression (secondary to malnutrition, alcoholism, diabetes, steroid use), previous corneal surgery (refractive corneal surgery, penetrating keratoplasty), extended wear contact lens use, pre-existing ocular surface diseases (dry eye, epithelial defect) and ocular trauma (agriculture- or farm-related) [1-8]. Annual rates of incidence include nearly one million clinical visits due to keratitis in the United States, while it has been reported that roughly two million people develop corneal ulcers in India. Clinically, patients may show signs of eye pain (ranging from mild to severe), blurred vision, photophobia, chemosis and redness. Pathogenesis is generally characterized by rapid progression, focal white infiltrates with underlying stromal inflammation, corneal thinning, stromal edema, mucopurulent discharge and hypopyon, which can lead to corneal scarring, endophthalmitis, and perforation. In fact, corneal opacity is not only a complication of keratitis, but among the leading causes of legal blindness worldwide. Despite that empirical treatment effectively controls most of the pathogens implicated in infectious keratitis, improved clinical outcomes are not guaranteed. Further, if treatment is not initiated in a timely manner, good visual outcome is reduced to approximately 50% of keratitis patients [9]. Moreover, resultant structural alterations, loss of tissue and an unresolved host response remain unaddressed through current clinical management of this condition.
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PMID:Understanding the Role of Pro-resolving Lipid Mediators in Infectious Keratitis. 3156 17

Microsporidium keratoconjunctivitis is an very rare disease. It is related to outbreaks in Asia due to exposure to contaminated water or soil. Microsporidium keratoconjunctivitis is a a self-limited disease, but it could have long term courses. We present the case of a 29 year old woman who started with pain, redness and blurred vision after a holiday in Singapore and did not respond to conjunctivitis treatment. PCR sequencing and PAS staining of corneal epithelial biopsy identified Vittaforma corneae as the causative organism. Treatment was initiated with corneal debridement, oral albendazol, and intensive topical voriconazole, levofloxacin and propamidine, but the conjunctival and corneal disease was only resolved 5 months later with the introduction of topical steroids to treat her severe limbitis. Suspicion of Microsporidium keratoconjunctivitis should be raised amongst ophthalmologists in unilateral keratitis with mild conjunctivitis in travelers from Asia.
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PMID:Vittaforma Corneae keratoconjunctivitis: An emerging pathology among travelers returning from Southeast Asia. 3266 Jul 63

A 52-year-old man presented with left eye redness, blurred vision, and photophobia. A history included marginal keratitis and conjunctival squamous cell carcinoma treated with excision and topical mitomycin-C. Examination revealed current marginal keratitis, managed with topical antibiotic and corticosteroid. Regular assessments included high-resolution optical coherence corneal tomography, refraction, and blood tests to exclude other causes of peripheral infiltrate and thinning. Two weeks later, visual acuity (VA) decreased and astigmatism increased. Significant refractive instability with astigmatism increased to 5.25 diopters with a corresponding decrease in VA. After 4 months of topical treatment, the marginal keratitis, astigmatism, and change in VA resolved. To the authors' knowledge, this is the first case report to describe an induced and fluctuating high-magnitude corneal astigmatic change in response to marginal keratitis.
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PMID:Inflammatory-induced astigmatism: acute changes in corneal curvature secondary to marginal keratitis and previous mitomycin-C treatment. 3294 86


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