Conjunctivo-cytologic changes in response to intense physical activity.

Possible cytological changes of the conjunctival fluid in association with physical activity were studied in a series of 39 subjects practising aerobics, 22 football players, and 29 marathon runners by means of the quantitative pipette method and the qualitative stix method of Norn. The first group was only examined after exercise, the two latter both before and after. No significant changes were detected in the cytologic composition of the conjunctival fluid in association with exercise.

[Eye care in Greenland in 1979-1988]. / Ojenlaegearbejdet i Grønland 1979-1988.

Specialist eye care in Greenland is described on the basis of 66 reports from all 30 visiting consultants during a ten-year period. During this time the durations of the visits increased to approximately seven months per year for 8-9 ophthalmologists who undertook approximately 2,500 consultations annually. The diagnoses were distributed as follows: 30% anomalies of refraction, 15% cataract, 12% conditions in the posterior segment and 10% glaucoma, i.e. a considerable proportion of eye diseases associated with advancing age and with a particular Greenlandic influence. The workload was particularly great and averaged more than a reasonable weekly load despite the increase in number of days of employment. Until 1985-1986, eye surgery activities showed a considerable increase after which operative interventions for cataract and glaucoma were mainly referred to Rigshospitalet. The great increase in the number of referrals is discussed in relation to the marked changes in the therapeutic possibilities for cataract and glaucoma: extracapsular cataract extraction with posterior chamber implantation using an operation microscope and YAG-laser iridectomy of early angle closure glaucoma. The requirement of an eye surgical unit in Greenland appears to be pressing together with continuation of specialist eye care in the districts.

Sodium hyaluronate in the treatment of keratoconjunctivitis sicca. A double masked clinical trial.

The effect of sodium hyaluronate eye drops in the treatment of severe keratoconjunctivitis sicca (KCS) was evaluated in a double masked crossover trial, comparing the effect of a 0.1% solution, a 0.2% solution and placebo in 20 patients. We found significantly decreased rose bengal staining and increased break-up time following 0.2% treatment compared to placebo. No significant difference was found in the Schirmer values and the cornea sensitivity. The patients significantly preferred sodium hyaluronate treatment. We conclude that sodium hyaluronate eye drops seem to be a valuable new agent in the management of KCS.

[Infectious conjunctivitis. The tear leukocyte esterase reaction (TLE) as a diagnostic aid]. / Infektiøs conjunctivitis. Tåreleukocyt-esterasereaktion (TLE) som diagnostikum.

Lacrimal fluid is absorbed on a cottonwool swab. This swab is pressed on the test field for leukocyte esterase on the stix. The colour change is read after exactly one minute. The sensitivity of the test is 90% and the specificity is 98% as assessed on 94 cases of infectious conjunctivitis and 439 normal individuals. The test is suitable for assessing cases of conjunctivitis in view of antibiotic therapy, control of contact lenses etc.

Tear fluid pH in normals, contact lens wearers, and pathological cases.

The pH of the conjunctival fluid was measured with a micro-glass-electrode in the inferior conjunctival fornix of 200 persons. Among 41 binocularly normal persons the pH was found to be 6.93 +/- 0.24 (mean +/- SD) of the primarily examined eye, independent of sex and age. The conjunctival fluid was significantly more acid in contact lens wearers (6.66 +/- 0.28, N = 26), but became normalized after removal of the lens (6.49 +/- 0.32----7.09 +/- 0.19, N = 8, P less than 0.001. The conjunctival fluid was significantly more alkaline in patients with lacrimal stenosis (7.13 +/- 0.28, N = 11), keratitis (7.14 +/- 0.28, N = 10), especially mycotic keratitis and postoperatively (7.15 +/- 0.22, N = 10, the first 24 h after corneal transplantation). There was, perhaps, a tendency towards alkalisation in eyes with keratoconjunctivitis sicca, whereas the pH was normal in the other pathological states, or the number of cases representing these may be too small.

Lipid pattern of plasma in the presence of episcleral lipid deposits.

Examination of 40 subjects aged under 70 with episcleral lipid deposits revealed an abnormal serum lipid pattern in 48% of all. No correlation was noticed between the number of lipid deposits and the raised plasma lipid concentration or the distribution of fatty acids (saturated, unsaturated).

Corneal and superficial conjunctival pigmentation in Eskimos, Mongols, and Caucasians.

Pigmentation was noticed on or round the cornea in 44% of 257 Eskimos (East Greenland) and 25% of 189 Mongols (Japan), but no more than 4% of 795 Caucasians in Denmark. Superficial pigmentation on the bulbar conjunctiva was seen in 58% of Eskimos, 48% of Mongols and 10% of Caucasians. In Eskimos it is in most cases localized nasally (54%). In Caucasians the inferior and superior sites predominate (39% and 30%, respectively). The prevalence in both groups was found to rise with increasing age and to be significantly highest among men. Pigmentation of the cornea alone was most frequent among Mongols (22%). Then followed Eskimos (14%) and Caucasians (2%) in decreasing order. The pigmentation on or round the cornea is independent of iris colour in Caucasians, but is related to melanosis of the bulbar conjunctiva, the caruncle and the plica semilunaris.

Episcleral lipid deposits and scleral plaques in Japan (Kyoto).

Screening of 189 Mongolian Japanese of both sexes in all age groups for scleral degenerations revealed presence of lipid deposits, especially round the anterior ciliary vessels, in 52%. The prevalence exceeds that among Caucasians in Denmark (N = 689), Eskimos in Greenland (N = 340), and Arabs in Jordan (N = 127), all examined by the same worker employing the same technique. Scleral plaques (well-defined transparency anterior to horizontal muscle) is present in no more than 0.5% of Japanese. This phenomenon is likewise rare among Eskimos, but frequent among Caucasians. The causes of the geographic differences are discussed.

Episcleral and subconjunctival lipid deposits. One year follow-up.

A series of 39 subjects, aged under 70, had the numbers of lipid globules counted in the slit lamp within 4 regions of the right eye and 4 regions of the left. The counting was repeated after an averaged period of 12 months (range 7-20 months). The investigation disclosed that the number of lipid globules rises. No instances were detected of a fall in their number, allowance being made for errors of measurement, assessed on the basis of blind double counting. The degeneration is not positively correlated to xanthelasma, diabetes mellitus, or presenile arcus.

Prevalence of episcleral and subconjunctival lipid deposits in Eskimos.

Slit lamp examinations of 340 Eskimos in Greenland revealed lipid deposits in 12%. The prevalence was significantly lower than in a Copenhagen series of Caucasians (45% out of 689 subjects) recorded for 10-year age groups. The numbers of lipid deposits seemed to be equal in lipid-positive subjects of the 2 ethnic groups, but the globules were more often localized temporally and more rarely superiorly in Eskimos than in Caucasians. The relatively rare occurrence of lipid deposits in Eskimos may possibly be due to the special composition of lipids on the blood and the rare occurrence of arteriosclerosis in Eskimos.

Spheroid degeneration, pinguecula, and pterygium among Arabs in the Red Sea territory, Jordan.

Report of an examination of 127 Arabs in the Red Sea City of Aqaba, Jordan. The results are compared with those of the author's examinations, using a similar apparatus, of 659 Eskimos in Western Greenland and 810 Caucasians in Copenhagen. Ultraviolet (u.v.) light is at a maximum in the Red Sea territory, considerable in Greenland, and negligible in Copenhagen. The prevalences of the following degenerative processes are high at the Red Sea, somewhat lower in Greenland, and low in Copenhagen: Climato-keratopathy gr. III (across the cornea, often with autofluorescent spheroids, always with conjunctival location as well), conjunctival spheroids (39%), and pinguecula (90% at the Red Sea). The prevalence of the conjunctival spheroid degeneration greatly exceeds that of the corneal. No difference is demonstrable between tropical and arctic keratopathy. The investigations performed gave results bearing out the view that u.v. light is responsible for all the above degenerative processes. Pterygium is equally frequent at the Red Sea and in Greenland. Lipid deposits (6%) and scleral plaques are not more prevalent at the Red Sea, a fact which argues against an ultraviolet genesis.

Incidence of Demodex folliculorum on skin of lids and nose.

The incidence of follicle mites (Demodex) has been studied in 206 non-selected subjects by means of adhesive tape impressions on skin during daytime of nose and lids and moist storage of the tape. The incidence was seen to rise with increasing age: 4% in young subjects, 30% in the age group of 20 to 80, and 47% in older. The mite was more often present on the skin of the nose (17%) than on that of the upper lid (8%), while the incidence on the lower lid was between these 2 extremes (13%). A total of 126 Demodex mites were detected (123 Demodex folliculorum and 3 Demodex brevis), all full-grown. Of these, 41% were ghosts. The migration was evenly distributed in all directions within the areas examined. About 0.2% of the mites can be roughly estimated to have migrated at a certain point of time from the follicles of the nose to its skin.

Conjunctival spheroid degeneration. Recurrence after excision.

After excision of part of the conjunctiva in 15 eyes (14 subjects) due to spheroid degeneration, the author noticed only fairly small, varying numbers of autofluorescent and colourless spheroids-after an observation period of 18 months, only 6% of autofluorescent and 13% of colourless bodies were observed compared to the number before biopsy. Around the biopsy site only a few spheroids were seen, with a non-significant tendency to increase in number of the colourless bodies. In the cornea the band-shaped keratopathy had aggravated, with the formation of a small number of large, autofluorescent spheroids. A pinguecula recurred in a mild degree only in 3 out of 13 cases within 18 months.