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Query: UMLS:C0595921 (intraocular pressure)
 11,750 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Topical and systemic steroids have proven to be invaluable agents in the treatment of a wide range of disorders, but their use is not without potential complications. Before initiation of therapy with systemic steroids, a personal or family history of cataracts, glaucoma, hypertension, diabetes, hyperlipidemia, renal stones, peptic ulceration, and current infection or pregnancy should be ascertained, because these patients have an increased risk of complications. Prior to long-term therapy with systemic steroids, blood pressure measurement, tuberculin skin test, and anergy panel are recommended. Monthly follow-up may include measurements of weight, blood pressure, electrolytes, and blood sugar and guaiac testing of the stool. To prevent the ocular complications of steroid therapy, routine screening is indicated (Table 1). Screening for cataracts, which occur most commonly as a sequela of continuous systemic steroid use, may be performed by slit-lamp examinations conducted three or four times a year for patients on long-term therapy and twice a year for patients taking intermittent topical ocular or systemic steroids. Glaucoma is more often associated with topical ocular or periocular steroids than with systemic steroids; recommended screening includes a baseline intraocular pressure measurement, then routine pressure measurements taken every few weeks initially, then every few months. Ocular rebound inflammation may develop secondary to rapid tapering or abrupt discontinuation of topical ocular steroid use and is best prevented with gradual tapering. Opportunistic infections of the eye include bacterial, viral, and fungal infections and are most often associated with the use of topical ocular steroids. Ophthalmologic evaluation is indicated promptly if patients treated with ocular steroids develop ocular discharge, pain, photophobia, or redness.
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PMID:Ocular effects of topical and systemic steroids. 161 9

Fifty patients (25 per group) with the signs and symptoms of allergic conjunctivitis confirmed by positive skin test enrolled in this randomized, double-blind, parallel group, 2-week comparison of pentigetide, 0.5%, ophthalmic solution (Pentyde) and cromolyn sodium, 4%, USP ophthalmic solution (Opticrom). The physician and the patient rated the patient's overall ocular condition on days 3, 8, and 15. On day 15 both the physician and the patients rated the pentigetide group as significantly (Chi-square, P less than .05) more improved than the cromolyn sodium group. The physician rated independently conjunctival symptoms and ocular signs at days 1, 3, 8, and 15. Improvement in signs and symptoms favored pentigetide in the majority of comparisons to cromolyn sodium (14 of 18). The pentigetide group showed significantly (ANOVA, P less than .05) greater improvement in hyperemia, edema, lacrimation, and blurred vision/photophobia. Patients completed daily diaries for seven symptoms. At the end of the study, comparisons to baseline between groups favored the pentigetide group for six of the seven symptoms; for itching, improvement favored significantly (ANOVA, P less than .05) the pentigetide group. The mean severity of all symptoms decreased by 64% in the pentigetide group as compared with a decrease of 46% in the cromolyn sodium group. Adverse experiences were minor and comparable in both groups. No clinically abnormal changes were noted for visual acuity, intraocular pressure, or common laboratory tests. This double-blind, active-controlled trial demonstrates that pentigetide, 0.5%, ophthalmic solution is safe and effective in the treatment of allergic conjunctivitis.
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PMID:Double-blind trial of pentigetide ophthalmic solution, 0.5%, compared with cromolyn sodium, 4%, ophthalmic solution for allergic conjunctivitis. 190 16

Primary congenital glaucoma is a rare but potentially devastating disorder that family physicians must recognize as early as possible in infants and young children. Symptoms, which may not be present at birth, classically include photophobia, excessive tearing and blepharospasm. The cornea may be enlarged and hazy. Increased intraocular pressure rapidly damages the optic nerve in infants. Treatment includes surgery with regular follow-up evaluation.
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PMID:Primary congenital glaucoma. 271 97

The effects of PGF2 alpha-isopropylester eye drops on intraocular pressure (IOP) and aqueous humour dynamics were investigated in healthy male volunteers. The other eye was treated with vehicle and used as a control. Special attention was also paid to adverse effects. Single and repeated doses were tested. There was a dose related effect on IOP. Significant reductions were observed 4, 8, and 12 hours after application of 1.0, 2.5, or 10 micrograms PGF2 alpha equivalents of the drug. With 10 micrograms the effect lasted 24 hours. An initial tendency towards an increase in IOP was observed for these doses. Repeated doses of 1.0 microgram daily or 0.5 microgram twice daily produced a significant and lasting IOP reduction of about 2 mmHg for 1-2 weeks. Aqueous humour production was not altered, and outflow facility was not significantly changed. There was a dose dependent hyperaemia with a maximum within 2 hours after application. A foreign body sensation, some pain, and photophobia were noted with increasing doses. A slight miosis of 1 mm was seen in three of six eyes treated with 10 micrograms. No signs of intraocular inflammation were recorded, but a slight increase in penetration of fluorescein into the anterior chamber was observed after 16 days of treatment.
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PMID:Prostaglandin F2 alpha-isopropylester eye drops: effects in normal human eyes. 275 73

We examined five patients with Down's syndrome and bilateral infantile glaucoma. In the first few months of life four patients had large cloudy corneas, breaks in Descemet's membrane, increased intraocular pressure, photophobia, and tearing. In one patient the diagnosis was delayed until 3 1/2 years of age because of concomitant nasolacrimal duct obstruction. Two patients developed cataracts and retinal detachment and have undergone multiple surgical procedures. The clinical course in these two older patients suggests that coexistence of congenital glaucoma, severe myopia, and cataracts in patients with trisomy 21 strongly predisposes for the development of retinal detachment and poor visual outcome.
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PMID:Infantile glaucoma in Down's syndrome (trisomy 21). 296 58

This was a double-masked, randomized, paired comparison with vehicle trial of a topically administered prostaglandin (PG)E2 in healthy human volunteers. A statistically significant decrease of the intraocular pressure in these non-glaucomatous volunteers occurred at six hours following one drop of 0.02% solution that persisted to the last measurement of IOP at the 24 hour examination. Significant elevation in the intraocular pressure was present at one and two hours following the eye drop instillation. All volunteers reported transient ocular side effects related to drug administration, including mild eye ache and intermittent photophobia for a duration of 2 to 4 hours. These symptoms were associated with a transient conjunctival vasodilation, but with no evidence of anterior chamber cells and flare or ciliary flush as determined by slit lamp examination. The results of this study suggest that PGE2, or a derivative, may offer a new class of topically effective ocular hypotensive agents useful in lowering the intraocular pressure of glaucoma patients.
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PMID:Topical prostaglandin E2 effects on normal human intraocular pressure. 317 31

After nine years, a boy was cured for his presumed allergic eye disease by microsurgical removal of intraocular sand particles, left in the anterior chamber after a childhood trauma. Sand being considered inert, together with seasonal variation in symptoms and misleading positive tests for allergy were to explain the doctor's delay. Involutive keratopathy eventually developed, with vessel ingrowth, severe photophobia and lacrimation, low intraocular pressure, and a visual acuity of only 1/60. Eight years after surgery there is a clear cornea and a corrected visual acuity of 6/12. The axial length of the diseased eye has remained longer than that of the healthy eye.
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PMID:Late keratopathy due to intraocular sand particles. A case history with misleading tests for allergy. 652 10

3 case studies of migrainous patients taking oral contraceptives (OCs) are presented in this report. The role of OCs in triggering a migraine attack and possibly elevating the risk of a stroke in a patient with migraines is examined. In the 1st case, a 27-year old white female accountant complained of temporal throbbing headaches associated with nausea, vomiting, hazy vision, small scotomas, and photophobia. The patient had been having the headaches twice a month since 1978 and she took Fiorinal to relieve them. Her physician diagnosed the headaches as migraine. The patient acknowledged that she started getting these headaches after beginning to use OCs 3 years earlier. Her family history revealed that her mother had severe migraine headaches which sometimes were accompanied by unilaterial paresthesia, as well as high blood pressure. Ophthalmoscopy, slitlamp, accommodation, and intraocular pressure findings were unremarkable. The patient was counseled about the factors which can trigger a migraine attack and was advised that eliminating these factors may reduce the frequency and intensity of the headaches. The patient was advised that OCs could increase her risk of having a stroke, especially with her family history. Her family physician subsequently reduced the dosage of her OCs. 5 months later the patient reported that she was trying to avoid the migraine triggering factors (e.g., she was wearing her sunglasses). Her headaches had become less frequent and less severe. The 2nd patient also began to have migraine attacks after beginning to use OCs. The 3rd patient's headaches became so severe after taking the pill that she consulted a neurologist. The 2nd and 3rd patients complained that the headaches were most severe at the time each month when they resumed OC use. None of the 3 patients discontinued OC use. The 2nd and 3rd patients were using a low estrogen OC, and the 1st patient was put on a low estrogen dosage after this optometrist's recommendation to her physician. Encouraging the patients to discuss the dosage of OCs with their family physician may be one of the ways to reduce the unwanted effect of the pill. The effect of OCs goes beyond triggering a headache. They may trigger a stroke particularly if the patient has a family history of high blood pressure as did the patients in this study. Differential diagnosis of migraine headaches includes muscle contraction, tension, sinus, and allergic headaches. Optometrists can be most helpful to the patients by counseling them to avoid the triggering factors. Glare, a triggering factor, could be reduced by tinted spectacles.
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PMID:Migraine and oral contraceptives. 714 75

A 57-year-old woman developed pain behind and above her left eye. She had a partial oculomotor nerve paresis manifest by slight blepharoptosis and a dilated pupil. Both anterior chamber angles were narrow but the left was partially occluded. There was no photophobia or corneal edema. Though the moderately increased intraocular pressure was controlled by medication, pain persisted and the oculomotor nerve palsy became complete 12 hours later. Cerebral angiography was done. She had an aneurysm of the left posterior communicating artery. The aneurysm was treated by neurosurgical techniques and the oculomotor paralysis resolved within a few months except for misdirection in regeneration.
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PMID:Acute angle-closure glaucoma secondary to an aneurysm of the posterior communicating artery. 738 66

The group of 60 patients suffering from chronic non-infected reaction of conjunctivits, showing irritation, conjunctival hyperemia, pain and photophobia, have been treated in the open observational clinical trial comparing the efficiency, safety and local tolerance of diclofenac sodium eye drops 0.1% (Naclof) versus dexamethasone eye drops (Dexamethasone oph. 0.1%) during a period of 30 days. Both medications were locally well tolerated. Naclof caused some slight temporary burning slightly more frequently than dexamethasone but the difference was not statistically significant (Naclof 89.7% tolerability and Dexamethasone 89.1% tolerability). The two drugs were equally effective in the treatment of chronic non-infected conjunctivitis. All the patients have shown a gradual improvement of the symptoms as well as of the objective sings. The dexamethasone group showed an increase in intraocular pressure at the third and fourth visit. However, these differences are not statistically significant either.
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PMID:[Naclof in the treatment of chronic non-infectious conjunctivitis]. 865 25


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