ABSTRACT
The association of keratoconus and atopic disease has been reported on several occasions but the only controlled clinical study that has so far been published found no evidence to support this view. Since it is now known that atopy is often associated with changes in various immunoglobulins, particularly IgE, it was considered desirable to determine the immunological profiles of a large series of keratoconus cases in order to seek evidence for coexistence of the two conditions in one individual. In this study of 182 cases of keratoconus a definite history of atopy was found in 35% compared with 12% in the matched control group. The serum IgE was significantly raised (P less than 0.001) in keratoconus and markedly so in those cases with associated atopic disease. Serum levels of IgG and IgM were also raised, but contrary to the findings of other observers IgA levels were normal. These findings suggest that atopic traits are more common in patients with keratoconus than in general ophthalmic patients.
Subject(s)
Hypersensitivity, Immediate/complications , Keratoconus/complications , Female , Humans , Immunoglobulin A/analysis , Immunoglobulin E/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Keratoconus/immunology , MaleABSTRACT
The study of 151 patients wearing soft hydrophilic lenses for one year revealed no gross irreversible lesions with loss of vision. But of significance was the presence of superficial lesions of the corneal epithelium, and chronic stromal oedema. While no significant loss of wearing time was noted for women taking the pill, the decrease in tear secretion in those patients with a latent dry eye problem could just alter the balance to produce intolerance. From this report it is the long-term changes to the tissues that remain to be fully investigated for soft hydrophilic lenses.
Subject(s)
Contact Lenses, Hydrophilic/adverse effects , Blepharitis/etiology , Corneal Diseases/etiology , Female , Humans , Keratitis/etiology , Male , Tears/metabolismABSTRACT
Fibrillary lines, whether in the normal cornea or in keratoconus, are faint structures which must be searched for diligently with the appropriate biomicroscopical settings, using a high magnification and oblique focal illumination of high intensity. They are unlikely to be confused with other superficial linear changes in the cornea, such as mare's tail epithelial lines, fingerprint lines and their variants, ring lines, and so on. A detailed description of these and other entities is given elsewhere (Brown and Bron, in preparation).