ASSOCIATION BETWEEN PHLYCTENULAR CONJUNCTIVITIS AND INTESTINAL PARASITES.

This study was carred out on fifty children suffering from Phlyctenular keratoconjunctivitis and attending ophthalmology outpatient clinics of Sohag University Teaching Hospital and Sohag Ophthalmology Hospital, of them 30 (60%) male and 20 (40%) females with age range from 6months to 14 years. Fifty stool samples were collected and examined microscopically for detection of any parasitic infection. 12(24%) cases were infected with Hymenolepis nana, one (2%) case was infected with E. hyistolytica, one case was infected Enterobius vermicularis, one case was infected with Giardia lamblia and one case was infected Tenia spp., regarding to age and sex distribution of the disease, male gender and age ranged from 6-8years were more affected, rural children were more affected than urbans one.

Prevalence of chronic ocular complications in Stevens-Johnson syndrome and toxic epidermal necrolysis.

PURPOSE: The aim of this study is to identify and grade the severity of chronic ocular complications in patients who suffered from Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) treated in Cape Town, South Africa. METHODS: A total of 54 patients with SJS or TEN for 6 months or longer were examined. The ocular complications were classified into corneal, eyelid and conjunctival complications. The complications were graded from 0 to 3 depending on the severity. RESULTS: A total of 108 eyes were included in the study. Medications caused SJS or TEN in all cases, and the most common associated drugs were anti-retroviral medications. 59.3% of patients were HIV-positive, with CD4 counts ranging from 6 to 521. Although only 11% of patients with SJS or TEN had acute ocular complications during the initial illness, 89% developed chronic ocular complications. Loss of the palisades of Vogt was the most common corneal complication. Among the six components of conjunctival and eyelid complications, irregularity of the mucocutaneous junction abnormalities was the most common, followed by mild conjunctival hyperemia. There was no statistically significant difference in the severity of chronic ocular complications between HIV-positive and HIV-negative patients (P = 0.4). In addition, the severity of chronic ocular complications was not statistically significantly associated with visual acuity loss (P = 0.3). CONCLUSION: We conclude that almost 90% of patients who are diagnosed with SJS or TEN will develop chronic ocular complications. Unless eyelids are severely affected, most chronic complications are mild to moderate ocular surface abnormalities and not necessarily vision-threatening complications.

Validation of ARIA duration and severity classifications in Spanish allergic rhinitis patients - The ADRIAL cohort study.

INTRODUCTION: Allergic rhinitis (AR) is an increasingly prevalent worldwide disease, which has an important impact on quality of life and generates high social and health care costs. The ARIA classification, that considers both the duration and severity of AR, seems more appropriate than previous classifications of AR, but few studies exist on the validation of the severity criteria proposed by the ARIA classification. OBJECTIVES: To assess the ARIA duration and severity classification of AR in a large sample population of patients, by investigating whether different degrees of severity correlate with differences in symptom score, quality of life or the patient's self evaluation of impairment. This study also assesses the relationship between AR severity and co morbidities. MATERIAL AND METHODS: An observational, cross-sectional, multicentre study conducted in Spain. AR was classified based on the ARIA criteria, and compared to the classical classification based on allergen exposure. Rhinitis was evaluated by the Total 4-Symptom Score (T4SS) scale, quality of life was measured using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and disease severity through a Visual Analogue Scale (VAS, 0-100 mm). Comorbidities were evaluated based both on the duration and severity of the symptoms of rhinitis. RESULTS: AR patients, (n = 3,529; mean age 37.5 +/= 13.4 years; 52.3% women) were included in the study. AR patients were classified as intermittent (51.5%) and persistent (48.5%) based on the ARIA classification, and as seasonal (61.2%), perennial (35.1%), and occupational (3.7%) based on the allergen exposure classification. Significantly higher T4SS, RQLQ and VAS scores were obtained in moderate/severe compared to mild AR. The incidence of asthma was significantly higher in patients with persistent and moderate/severe AR compared to intermittent and mild AR. Asthma was the only co morbidity to reach statistical significance. CONCLUSION: ARIA classification of severity reflects two different statuses of AR in terms of symptoms and quality of life. Asthma was the only concomitant pathology in which incidence was related to ARIA categories in terms of duration or severity.

The use of fractal analysis and photometry to estimate the accuracy of bulbar redness grading scales.

PURPOSE: To use physical attributes of redness to determine the accuracy of four bulbar redness grading scales, and to cross-calibrate the scales based on these physical measures. METHODS: Two image-processing metrics, fractal dimension (D) and percentage of pixel coverage (% PC), as well as photometric chromaticity were selected as physical measures, to describe and compare grades of bulbar redness among the McMonnies/Chapman-Davies scale, the Efron Scale, the Institute for Eye Research scale, and a validated scale developed at the Centre for Contact Lens Research. Two sets of images were prepared by using image processing: The first included multiple segments covering the largest possible region of interest (ROI) within the bulbar conjunctiva in the original images; the second contained modified scale images that were matched in size and resolution across scales, and a single, equally-sized ROI. To measure photometric chromaticity, the original scale images were displayed on a computer monitor, and multiple conjunctival segments were analyzed. Pearson correlation coefficients between each set of image metrics and the reference image grades were calculated to determine the accuracy of the scales. RESULTS: Correlations were high between reference image grades and all sets of objective metrics (all Pearson's r >or= 0.88, P

Atualização no diagnóstico e tratamento das conjuntivites / Highlights on conjunctivitis diagnosis and treatment

As conjuntivites representam freqüente causa de consultas ambulatoriais, razão pela qual se torna relevante atualizar a comunidade médica acerca do adequado diagnóstico e tratamento das mesmas. Assim, neste artigo, os autores apresentam uma revisão da literatura, atualizando os conhecimentos relativos ao diagnóstico e tratamento das principais formas de conjuntivites, quais sejam: viral, bacteriana, neonatal, alérgica e tóxica

Conjunctivitis represent frequent cause of ambulatorial medical visits. In this regard, it is very important to bring the medical staff up to date concerning its diagnosis and treatment. Thus, in this paper, the authors present a review of literature about the diagnosis and treatment of the main forms of conjunctivitis, which are: viral, bacterial, allergic, neonatal and toxic

The important role of nontypable Streptococcus pneumoniae international clones in acute conjunctivitis.

BACKGROUND: In a recent epidemiological study in southern Israel, nontypable Streptococcus pneumoniae isolates were found to be highly associated with sporadic cases of acute conjunctivitis (AC). The purpose of the present study was to evaluate the relative importance in causing AC of the absence of capsule versus genotype properties. METHODS: DNA typing by pulsed-field gel electrophoresis (PFGE) was performed on 148 nontypable organisms isolated from 3 sites: nasopharynx of healthy children, middle-ear fluid, and conjunctiva. RESULTS: Analysis of the PFGE patterns revealed the presence of 6 clusters; 2 clusters that included 44% of the isolates (65/148) were associated with AC, and the remaining 4 were frequently isolated from the nasopharynx. Multilocus sequence typing, performed on representative isolates of the 2 major clusters, confirmed that the organisms were pneumococci; one is a single-locus variant of sequence type (ST) 448, and the other is related to ST344. Both types appear to be members of pneumococcal lineages that have lost capsular loci. The nontypable isolates showed high rates of resistance to antimicrobial agents. CONCLUSIONS: Our data suggest that the absence of the capsule--along with other, yet-unidentified genetic characteristics--provide S. pneumoniae with a selective virulence advantage in conjunctivitis.

Seasonal non-allergic rhinitis (SNAR)--a new disease entity? A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent non-allergic rhinitis.

We have earlier described a group of patients suffering from rhino-conjunctivitis during the early pollen season, but with negative allergological investigation. The present study aimed to evaluate this syndrome called Seasonal Non-Allergic Rhinitis (SNAR). Seventeen patients with SNAR were compared with 20 patients with seasonal allergic rhinitis (SAR) and 13 patients with persistent non-allergic rhinitis (PNAR). They were analyzed with skin prick tests (SPT) and nasal provocation tests (NPT) with pollen extracts, and for IgE antibodies in serum and inflammation mediators in nasal lavage. Daily symptoms and medicine consumption were recorded. Late reactions after SPT occurred in two SNAR, eight SAR and two PNAR patients. Weak immediate and late reactions after NPT were induced in 3/15 and 7/15 SNAR patients, respectively, and in 1/13 and 5/13 PNAR patients. All SAR patients had immediate and 9/18 had late reactions. The total IgE levels were lower in SNAR compared to SAR. In the SNAR group 1/15 was positive in Phadiatop. Increased tryptase levels after NPT were only observed in SAR. The SNAR patients had high daily symptom scores already before birch pollen season. Sneezing was more common in SNAR and SAR than in PNAR; eye-symptoms more prominent in SAR than in SNAR or PNAR. SNAR seems to be different from SAR and PNAR regarding immunological mechanism and symptom period. We conclude that the cause of SNAR is unknown.

[Tropical endemic limbo-conjunctivitis in Lúbumbashi, Democratic Republic of the Congo]. / La limbo-conjonctivite endémique des tropiques à Lúbumbashi, République Démocratique du Congo.

PURPOSE: To determine the frequency and clinical characteristics of tropical endemic limbo-conjunctivitis (TELC). METHODS: A review of records of all patients aged 0-15 years with a diagnosis of tropical endemic limbo-conjunctivitis examined between January 2000 and February 2002. The diagnosis was based on interview and routine ocular examination. RESULTS: A total of 139 patients out of 422 patients had the diagnosis of TELC, giving a relative frequency of 32.9%. The average age with TELC was 6.5 years which was lower than that of patients without TELC (7.6 years). The sex distribution didn't show any difference between the two sexes (P = 0.345). Children aged 0-4 years were the most affected by the disease. Itching (86%), red eye (51%), brown eye (48%), and tearing (48%) were the most frequent complaints encountered. Photophobia was only seen in 12% of patients. The distribution of the types of the disease was: palpebral form (58%), mixed form (39%) and limbal form (3%). CONCLUSION: One out of three children 0-15 years of age who consulted suffers from LCET in Lubumbashi; although other African studies reported difference in distribution in sex and the predominance of the limbal (bulbar) form of the disease, such data were not found in this study. The disease was equally distributed among sexes and the palpebral form was the most frequently encountered. Complications are uncommon. Other studies are needed to confirm the findings of this study.

Biocompatibility of electrochemically activated aqueous solutions: an animal study.

The purpose of the study was to evaluate the biocompatibility of electrochemically activated aqueous solutions on experimental animals. Nine rabbits were subjected to acute eye irritation/corrosion tests, nine rabbits to acute dermal irritation/corrosion and 30 rats to acute oral toxicity (LD50) tests. No significant negative effects were noted. Considering the relatively high levels of exposure of the animals to the solutions and the low levels in the anticipated real clinical situation it is argued that these solutions are indeed biocompatible.

A puzzling case: conjunctivitis lignosa?

We describe the clinical history, histopathology and treatment of a two and a half year old boy. He presents with a chronic, unilateral and (pseudo) membranous conjunctivitis, preceded by ear-nose-throat problems and arthritis. The case was considered to be a ligneous conjunctivitis. Treatment consisted of repeated removal of the membranes, combined with topical hyaluronidase, alpha-chymotrypsin, cyclosporin, heparin and antibiotics, and was deceiving.

Ojo rojo, una afección grave? / Red eye, a dangerous disease?

Al enfrentar este problema, el médico debe considerar como diagnósticos diferencial la posibilidad de conjuntivitis, iritis, glaucoma agudo, úlcera corneana, queratitis herpética o traumatismo de la cornea. En este artículo se pasa revista a las principales claves diagnósticas y a las bases de la terapéutica de cada una de estas enfermedades.

The red eye.

The patient with a red eye constitutes a very common clinical problem encountered in the Emergency Department setting. Conjunctivitis, the most common cause of the red eye, generally is not associated with disturbance of vision or associated ocular pain. If either of these symptoms is present, a more serious disorder must be suspected. Treatment of infectious conjunctivitis is guided by interpretation of a Gram's stain and subsequent culture of any exudate present. Initial treatment of most cases includes use of topical antibiotic and local comfort measures. Complications of infectious conjunctivitis include more invasive disease such as keratitis or abscess formation, with potential corneal perforation and destruction. All patients should be referred for ophthalmologic followup, both to assess adequacy of treatment and to treat unexpected complications. Remember that allergic conjunctivitis is a common condition that responds to antihistamine decongestant medications given orally or topically. Occasionally these conditions are caused by self-prescribed use of ocular medication, and discontinuation of all eye medication is required. Corticosteroid eye drops are rarely indicated and should be used only at the direction of an ophthalmologist. When the diagnosis is uncertain, treatment is best withheld, as "shotgun" therapy is seldom beneficial.

An epidemic of acute hemorrhagic conjunctivitis in the city of Sao Paulo.

This is a clinical and laboratory report on 98 patients with acute viral conjunctivitis who were referred to the Eye Clinic of the Escola Paulista de Medicina of Sao Paulo, Brazil, from February 1983 to February 1984. It was planned with the objective of confirming the importance of adenovirus and enterovirus 70 as etiological agents of viral conjunctivitis. The occurrence of an outbreak of acute hemorrhagic conjunctivitis during the summer of 1984 permitted a better study of enterovirus 70. In addition, we could demonstrate that sporadic cases, from March to July 1983, were caused by the same virus. This fact confirmed the idea that the spread of the disease was not related to the recent arrival of the virus in the community, but to weather conditions of heat and high humidity.