Superior limbic keratoconjunctivitis in identical twins.

The first two cases of superior limbic keratoconjunctivitis occurring in identical twins are reported. In both cases the symptoms began 16 years ago and have never permanently responded to numerous topical medications or to bilateral resection of the superior bulbar conjunctiva.

Excimer laser therapy for experimental Candida keratitis.

In vivo treatment of experimental Candida albicans keratitis with the excimer laser achieved sterilization on culture and histopathologically in all corneas in which clinically visible infiltration was removed with the laser at the 193-nm wavelength. Treatment at the 248-nm wavelength was not successful in eradicating infection compared with untreated controls. The 193-nm wavelength is highly effective, probably because infected tissue is totally removed by ablative photodecomposition. At the 248-nm wavelength, thermal effects become more dominant and, therefore, fungal elements are incompletely ablated. Light microscopy two days after treatment at the 193-nm wavelength showed healing of ulcerated areas, fine basophilic stippling at the epithelial-stromal interface, and undamaged underlying stroma.

Norfloxacin and silver norfloxacin in the treatment of Pseudomonas corneal ulcer in the rabbit.

Norfloxacin is a new synthetic antibiotic with a broad spectrum of activity against gram-positive and gram-negative bacteria, and is more effective than the aminoglycosides against P aeruginosa. In this study norfloxacin was particularly effective in treatment of P aeruginosa infection of the rabbit cornea, and caused no toxicity in normal rabbit eyes after prolonged administration. The addition of silver to norfloxacin enhances its antipseudomonal activity, and broadens its spectrum to include antifungal activity. In this study, silver norfloxacin appears to be the most effective antibiotic against P aeruginosa corneal ulcer in the rabbit. Because of its broad antibacterial spectrum, silver norfloxacin may be useful in the initial treatment of bacterial corneal ulcer before the identity of the bacteria is known. Because of its low toxicity in topical administration, and its antifungal and antibacterial activity, silver norfloxacin may be helpful in prophylaxis against infection in chronic corneal ulcers.

Fibrous histiocytoma of the corneoscleral limbus: The ultrastructure of a distinctive inclusion.

A case of epibulbar fibrous histiocytoma is presented, with emphasis on the electron microscopic aspects due to the paucity of ultrastructural descriptions of this rare tumor. A tan-yellow conjunctival tumor developed at the corneoscleral limbus in a 31-year-old male. The clinical diagnosis was confirmed by routine histopathologic evaluation, which demonstrated a typical matted or storiform cellular pattern. Electron microscopy revealed a mixed cell population, composed primarily of histiocytic and fibroblastic cells. The histiocytic cells contained lysosomes and phagosomes and had interdigitating cell processes. The fibroblastic cells were characterized by prominent rough-surfaced endoplasmic reticulum and variable amounts of lipid within vacuoles, but did not possess lysosomes or phagosomes. Both cells occasionally contained an unusual curvilinear structure, suggesting a shared histogenesis. This distinctive inclusion appeared to be a modification of the rough-surfaced endoplasmic reticulum. The nature and origin of the tumor cells are discussed on the basis of their ultrastructure.

Hepatitis B surface antigen in human tears.

The incidence of hepatitis B virus infection has been increasing every year in the United States, particularly among medical personnel. Only half of these cases are associated with exposure to blood or blood products. Respiratory, fecal-oral, and venereal methods of transmission of hepatitis B virus infection are supported by epidemiological evidence and by the demonstration of hepatitis B surface (HBsAg) antigen in several body secretions. In this investigation, tears were collected from patients whose serum was positive for HBsAg. These tears were tested for the same antigen, which was found to be present in half the cases. There is a risk of transferring hepatitis B virus infection by tonometers or soft contact lenses contaminated by HBsAg.