Frequência de ocorrência das afecções dos anexos oculares e do olho externo / Frequency of occurrence of affections of the adnexa and external eye

RESUMO Objetivo: Observar a frequência de ocorrência das afecções que acometem os anexos oculares e o olho externo, assim como descrever o perfil demográfico dos portadores, na região centro oeste do estado de São Paulo. Métodos: Estudo prospectivo, populacional e aleatorizado, no qual foram avaliadas 11.000 pessoas da região centro-oeste do Estado de São Paulo, nos anos de 2004/2005, por meio de consultas oftalmológicas e utilizando uma unidade móvel. Foi realizado exame oftalmológico completo. Os dados foram transferidos para tabela Excel, utilizando-se para o presente estudo dados referentes aos anexos e doenças do olho externo. A frequência de ocorrência dos problemas detectados foi analisada estatisticamente. Resultados: Foram detectadas 1.581 (14,6%) afecções de anexos ou do olho externo, sendo as mais frequentes o pterígio (9,4%), o hordéolo (0,8%) e as alterações do posicionamento palpebral (1,7%) (ectrópio, ptose e triquíase). Trauma, ectrópio e pterígio foram estatisticamente mais frequentes na população masculina. Conclusão: Das afecções pesquisadas, a de maior ocorrência na população foi o pterígio, seguido das alterações inflamatórias e do posicionamento palpebral.

ABSTRACT Purpose: To observe the frequency of occurrence of affections involving the adnexa or the external eye, as well as to describe the demographic profile of patients. Methods: A prospective, population based, randomized study was done in the Midwest region of the state of São Paulo, in the years 2004/2005. Using a Mobile Ophthalmic Unit we evaluated 11,000 people. A comprehensive eye exam was performed. Data were transferred to excel table and for this study we used information relating to annexes and external eye diseases. The frequency of occurrence of the problems detected was statistically analyzed. Results: We identified 1,581(14.4%) disorders in the adnexa or in the external eye. The most common disorders were pterygium (9.4%), hordeolum (0.8%) and changes in eyelid position (1.7%) (ectropion, ptosis and trichiasis). Trauma, ectropion and pterygium were statistically more frequent in the male population. Conclusion: Of the surveyed disorders the most frequent in the population was pterygium, followed by inflammatory changes and alterations in the eyelid position.

Incidencia y fármaco-resistencia de cepas de Staphylococcus spp aisladas de exudados conjuntivales / Incidence and drug-resistance of Staphylococcus spp strains isolated from conjunctival swabs

OBJETIVO: Determinar la incidencia de cepas del género Staphylococcus aisladas de exudados conjuntivales y analizar su resistencia frente a diferentes antimicrobianos. MÉTODOS: Se realizó un estudio observacional descriptivo retrospectivo en el que se revisaron 3554 exudados conjuntivales a pacientes que acudieron en el período comprendido entre enero de 2002 a diciembre de 2003 y desde enero de 2005 hasta diciembre de 2007 al Instituto Cubano de Oftalmología Ramón Pando Ferrer por presentar un diagnóstico de infección ocular externa. RESULTADOS: Se aislaron 874 cepas de Staphylococcus aureus para un 47,5 por ciento y 965 cepas de Staphylococcus spp. coagulasa negativa con prueba de patogenicidad positiva para un 52,4 por ciento. En 69 de esos exudados los cultivos presentaron etiología mixta con dos bacterias diferentes, para el 3,7 por ciento. Se determinaron los porcentajes de resistencia a las cepas aisladas pertenecientes al género Staphylococcus. CONCLUSIONES: Se encontró una alta incidencia de las especies del género Staphylococcus en las infecciones oculares, así como se pudo apreciar que la menor fármaco-resistencia para Staphylococcus aureus y Staphylococcus spp. coagulasa negativa correspondieron a los antimicrobianos ciprofloxacina y amikacina. La mayor fármaco-resistencia de las cepas de Staphylococcus aureus correspondió a eritromicina y tetraciclina y en Staphylococcus spp coagulasa negativa fue frente a la tetraciclina

OBJECTIVE: To determine the incidence of Staphylococcus strains isolated from conjunctival swaps and their resistance to several antimicrobial agents. METHODS: A retrospective, descriptive and observational study was performed to review 3554 conjunctival swabs from patients who went to Ramón Pando Ferrer Institute of Ophthalmology in the period from January 2002 to December 2009 due to a diagnosis of external ocular infection. RESULTS: From the total of conjunctival swabs, 874 Staphylococcus aureus strains (47.5 percent) and 965 (52.4 percent) negative Staphylococcus spp. coagulasa strains were isolated, being pathogenecity test positive in 52.4 percent. In 69 swabs, the cultures presented mixed etiology with two different bacteria accounting for 3.7 percent. Resistance percentages of Staphylococcus strains were estimated. CONCLUSION: The incidence of Staphylococcus species in eye infections was high and the drug resistance for Staphylococcus aureus and Staphylococcus spp. coagulasa negative to Ciprofloxacin and Amikacyn was lower. The greatest drug resistance of S. aureus strains corresponded to erythromycin and tetracycline whereas Staphylococcus spp coagulasa negative were more resistant to tetracycline

Ocular dirofilariasis in Dubai, UAE.

A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics.

Epidemiología de las lesiones conjuntivales y su correlación clínico-patológica / Epidemiology of conjunctival lesions and clinical-pathological correlation

Se realizó una revisión de los 1166 casos de lesiones conjuntivales recibidos por el Laboratorio de Patología Ocular del Hospital Clínico de la Universidad de Chile entre los años 1968-2005. En base a ella se describen los distintos diagnósticos histopatológicos según su frecuencia, distribución por sexo, edad, localización y tiempo de evolución. La edad promedio para los casos fue de 36 años con un 51,5 por ciento de hombres afectados y un tiempo de evolución promedio de 68 meses. Las lesiones más frecuentes fueron las pigmentarias (44,2 por ciento), seguidas de las epiteliales (22,7 por ciento) y los cuadros infecciosos (10,9 por ciento). La localización más frecuente para todas las lesiones fue bulbar. Se estableció, además, una correlación entre los diagnósticos clínicos e histopatológicos, la cual resultó ser positiva en un 60,9 por ciento, siendo marcadamente superior para las lesiones pigmentarias e inferior para lesiones degenerativas, cuadros infecciosos y tumores clasificados como pre-malignos o malignos.

We made a retrospective review of 1166 cases of conjuntival lesions, accepted for its study at the Laboratory of Ocular Pathology, University of Chile, from 1968 to 2005. Based on this survey, different histopathologic diagnosis were described, characterized by its frequency, gender distribution, age, location and time of evolution. The average age was 36 years, with a 51,5 percent being male, and an average time of evolution of 68 months. Most frequent lesions were pigmented (44,2 percent), followed by epithelial (22, 7 percent), and infectious diseases (10,9 percent). The most frequent location was bulbar. A clinical - pathologic correlation was established, being positive in 60,9 percent of cases. It was noticeable superior for pigmented lesions, and inferior for degenerative lesions, infectious disease and tumors classified as pre malignants or malignants.

Oculosporidiosis in a tertiary care hospital of western Orissa, India: a case series.

The authors present a case series of 54 subjects of Rhinosporidium. They were reported in two years at a tertiary care hospital of Western Orissa. The clinically diagnosed cases by ophthalmologists were confirmed by histopathological samples following surgery. In our series, we noted Rhinosporidium seeberi organisms as the main causative agent. Males were affected three times more than females. Children less than 10 years of age comprised more than 50% of our series. In 91% of cases, the conjunctiva was the site of this infection. Total excision of fungal mass was carried out in all cases and two cases had recurrence between 9 and 12 months following intervention. Although this is an endemic area for such infestation, unilateral manifestation observed in all cases is interesting to note. Low recurrence rate in limited follow-up period could be due to early detection and standard management.

Prevalence of biomicroscopic findings in the anterior segment and ocular adnexa among schoolchildren in Natal/Brazil

OBJETIVO: Determinar a prevalência dos achados oculares das estruturas externas e segmento anterior do olho detectados ao exame biomicroscópico em uma população de estudantes de Natal (RN) - Brasil. MÉTODOS: 1024 escolares do ensino fundamental e médio de escolas públicas e privadas da cidade de Natal foram avaliados de março a junho de 2001 após seleção randomizada prévia. Todos foram submetidos a protocolo de pesquisa pré-estabelecido consistindo em identificação, dados demográficos e exame oftalmológico biomicroscópico com lâmpada de fenda, realizados por oftalmologistas do Hospital Universitário Onofre Lopes. RESULTADOS: As alterações da conjuntiva e das pálpebras foram as mais prevalentes, (10,4% e 6,2% respectivamente). Dentre estas, folículos e papilas conjuntivais representaram os achados mais evidenciados ao exame da conjuntiva (4,2% e 3,0% respectivamente), ao passo que blefarite anterior (3,5%) e meibomite (1,1%) foram as anormalidades mais encontradas nas pálpebras. Ao exame da córnea, íris, cristalino e vítreo anterior, os achados mais freqüentes foram: nubécula (0,5%), restos da membrana pupilar (0,5%), opacidade de cápsula posterior (0,8%) e resquício da artéria hialóide (2,0%). CONCLUSAO: Os achados mais prevalentes acometeram com maior freqüência as estruturas externas do olho (pálpebras e conjuntivas), tendo como seus principais representantes a blefarite anterior e reação folicular da conjuntiva, respectivamente. Já as anormalidades mais evidenciadas na córnea, íris, cristalino e vítreo anterior foram: nubécula, resquício da membrana pupilar, opacidade da cápsula posterior e resquício da artéria hialóide, nesta ordem.

Subconjunctival dirofilariasis in India.

Human dirofilariasis caused by Dirofilaria repens, have been reported to occur widely throughout Asia, Europe and Africa. Reports of this infection from India are however limited. Herein we report a case of subconjunctival dirofilariasis from Karnataka state of India. A 42 year old man presented with a history of pain and swelling in the left eye. A live parasite measuring 3.5cm in length was surgically removed from the nodular swelling in the conjunctiva. The parasite was identified as Dirofilaria repens, adult male.

Prevalencia de pterigio, pingüecula hiperplasia conjuntival entre trabajadores de una empresa cementera de Bogotá / Prevalence of pterygia, pingueculae, and conjuntival hiperplasia among cement workers from Bogotá

Un estudio exploratorio retrospectivo fue realizado con 195 trabajadores de una empresa cementera, con el fin de explorar la asociación entre la exposición a polvo de cemento y la ocurrencia de pterigio, pingûecula e hiperplasia conjuntival. En 1998 una optómetra realizó los exámenes físicos, encontrando que las prevalencias de alteraciones conjuntivales en la población estudiada fueron: 37,4 % para la pingûecula, 23,6 % para la hiperplasia conjuntival y 19 % para el pterigio. Los trabajadores fueron clasificados en tres grupos según los niveles de exposición encontrados en la inspección del lugar de trabajo realizado por un especialista en salud ocupacional. Los resultados de la comparación de estos grupos sugieren una asociación entre la exposición a polvo de cemento y el pterigio (RPa: 9,8; IC95%: 1,4-68,8). Se plantea la necesidad de realizar nuevos estudios para mejorar el conocimiento de la etiología de las alteraciones conjuntivales, así como realizar los cambios en el ambiente laboral e implementar el uso de elementos de protección ocular.(AU)

A retrospective exploratory study was realized with 195 cement workers to explore the association between cement dust exposure and the occurrence of pterygia, pingueculae, and conjuntival hiperplasia. An optometrist examined the population in the enterprise during 1998. The prevalences of conjuntival alterations were: pingueculae 37,4 %, conjuntival hiperplasia 23,6 %, and pterygia 19 %. The workers were classified in three groups according to exposure levels determined by an occupational health specialist. The findings of the group comparison suggest an association between cement dust exposure and pterygia (PRa: 9,8; IC95 %: 1,4-68,8). New studies are required to improve the knowledge about the etiology of conjuntival alterations. Changes in the occupational environment and personal protective elements are recommended to guarantee ocular health.(AU)

A first record from Thailand of human external ophthalmomyiasis due to Oestrus ovis.

A case of external ophthalmomyiasis caused by Oestrus ovis was first reported from Lopburi Province, Central part of Thailand, in January, 1997. A 18-year-old man presented with a several hours history of foreign body sensation in his left eye accompanied by irritation. Eight Oestrus ovis first-instar larvae were removed from lower palpebral conjunctiva. Symptoms and clinical signs resolved in 24 hours after mechanical removal of the larvae. There was no history of contact fly and domestic animals. The larvae were identified by light microscopic examination.

A study of ocular complications in leprosy.

A total of 380 leprosy patients were studied in four different leprosy hospitals. The involvement of eye was found in 18.95% of cases in which 10.97% in lepromatous leprosy and 8.16% in non-lepromatous leprosy cases. In total cases studied 52.63% were of lepromatous leprosy and 47.37% of non lepromatous leprosy cases. Among them 11.05% were males and 18.95% were females. In 72 cases of ocular involvement, males constituted 80.56% and females 19.44% of cases. Maximum cases (52.78%) of ocular involvement were in leprosy patient with 5 to 10 years of duration. Blindness among the total leprosy patients studied was 1.84% which was mainly due to corneal opacity following exposure keratitis and ulceration, iridocyclitis and its complications.