Accommodative asthenopia among Romanian computer-using medical students-A neglected occupational disease.

Computers have become to play an important role in people's lives throughout the world thus increasing the number of patients with ocular complaints. Also known as computer vision syndrome, accommodative asthenopia might be considered as a neglected occupational condition, but there is no consensus regarding diagnostic criteria, which leads to under-recognition and under-reporting. The aim of the study was to investigate the prevalence, early symptoms and specific preventive measures of accommodative asthenopia among computer-using medical students (n = 420), in a cross-sectional study. The most common early symptoms were: tired eyes/eye strain (86.1%), burning eyes (46.8%), migraines/headaches (46.8%), red-swollen eyes (43%), photophobia (41.8%), temporary blurred vision (35.4%), and eyelid spasms (32.9%). Our study identifies the most frequent early symptoms of accommodative asthenopia as a possible occupational disease, which might serve as a fundament for a future consensus strategy.

A rare association of cutaneous leukocytoclastic angiitis (hypersensitivity vasculitis) and hypersensitivity pneumonia (extrinsic allergic alveolitis) in a pigeon breeder - case report and literature review.

Extrinsic allergic alveolitis is an occupational condition intensively studied and published about, unlike cutaneous leukocytoclastic angiitis. The coexistence of these two diseases is even more rare in the same patient with exposure to occupational pollutants of animal origin. We present the case of a 44-year-old man, a pigeon breeder admitted to hospital with a pruritic purpuric eruption and lower limb paresthesia, dyspnea on exertion, polymyalgia rheumatica, mixed polyarthralgias. Based on the clinical, paraclinical and laboratory investigations (electroneuromyography, plethysmography, computed tomography scan, musculocutaneous biopsy, current laboratory tests and immunoassays), the main diagnoses of extrinsic allergic alveolitis and leukocytoclastic vasculitis were determined. The patient underwent treatment with corticosteroids with a favorable outcome, but which becomes aggravated by the occurrence of necrotic skin lesions at the cessation of corticosteroid therapy on the patient's own initiative. After the resumption of the corticosteroid therapy, the lesions and symptoms improve. To our knowledge, this case report is the first one that describes an association of two major conditions, extrinsic allergic alveolitis and cutaneous leukocytoclastic angiitis, in the same clinical context of an occupational exposure to specific pollutants. Long-term corticosteroid therapy has proved to be useful in preventing relapses and improving the patient's clinical status with the association of cutaneous leukocytoclastic angiitis and extrinsic allergic alveolitis. Considering our findings in this case report, we may suggest the inclusion of systemic vasculitis on the list of recognized professional diseases.