Acute and chronic conjunctivitis due to over-the-counter ophthalmic decongestants.

OBJECTIVE: To describe patterns of conjunctivitis caused by ophthalmic decongestants. DESIGN: Case series. SETTING: Outpatient eye clinic. PATIENTS: We selected patients with conjunctival inflammation who were using nonprescription decongestant eyedrops, who had no other cause for conjunctivitis, and whose conditions improved after discontinuing the incriminated preparations. MAIN OUTCOME MEASURES: Clinical characteristics of conjunctival inflammation and time to resolution of symptoms and signs after discontinuing the use of eyedrops. RESULTS: Seventy patients (137 eyes) were identified. Preparations containing the vasoconstrictors naphazoline, tetrahydrozoline, or phenylephrine were associated with 3 clinical patterns of conjunctivitis: conjunctival hyperemia (50 cases), follicular conjunctivitis (17 cases), and eczematoid blepharoconjunctivitis (3 cases). Decongestants were used daily for a median of 3 years (range, 8 hours to 20 years) prior to presentation. The median time to resolution of symptoms and signs was 4 weeks (range, 1-24 weeks), and patients remained asymptomatic for a median follow-up of 6 months (range, 0-12 years). CONCLUSION: Nonprescription decongestant eyedrops can produce acute and chronic forms of conjunctivitis by pharmacological, toxic, and allergic mechanisms. Once recognized, conjunctival inflammation often takes several weeks to resolve.

Topical FK-506 prevents experimental corneal allograft rejection.

We evaluated the efficacy of topical cyclodextrin-encapsulated FK-506 in the prevention of experimental corneal allograft rejection. Two weeks after inducing corneal inflammation and neovascularization with 8-0 silk sutures, 23 albino rabbits received a unilateral 8-mm diameter central penetrating corneal allograft from pigmented donors. Rabbits were randomly assigned to no treatment (eight eyes), topical cyclodextrin four times daily for 28 days (seven eyes), or topical FK-506 0.3 mg/ml in a cyclodextrin suspension (eight eyes) four times daily for 28 days. Grafts were examined daily for degree of inflammation, neovascularization, edema, and signs of rejection for up to 100 days. Seven of eight (88%) untreated grafts and five of seven (71%) cyclodextrin-treated grafts rejected at a median of 3 weeks after transplantation, whereas only two (25%) of eight FK-506-treated grafts rejected and did so at a significantly longer interval (p < 0.005). Topical FK-506 prevents or delays corneal allograft rejection after experimental corneal transplantation.

Visual results and complications of phacoemulsification with intraocular lens implantation performed by ophthalmology residents.

The authors retrospectively analyzed the visual outcome and incidence of complications of 181 consecutive cases of phacoemulsification performed by eight third-year ophthalmology residents. A posterior chamber intraocular lens was implanted in 179 of these eyes. Vitreous loss occurred in 5.5% of cases. The overall incidence of posterior capsule rupture was 9.9%; of the 18 posterior capsular ruptures, 72% were detected during cortical removal and 22% during nuclear emulsification. Postoperative follow-up for 177 eyes was at least 2 months, and 70% were followed for 6 months or longer. Final best corrected visual acuity of 20/40 or better was obtained in 92.6% of eyes. These results are comparable with previous reports of residents' experience in performing planned extracapsular cataract extraction. With appropriate training and faculty supervision, residents learning to perform phacoemulsification and intraocular lens implantation can achieve acceptable results.

Statement-Pie: a strategy to improve the paragraph writing skills of adolescents with learning disabilities.

This study investigated the effects of teaching a metacognitive text structure strategy upon the paragraph writing skills of eighth-grade students with learning disabilities. The technique, called Statement-Pie (Hanau, 1974), teaches students to understand the relationship of supporting details to a main idea. Four students were taught to use an outline as a paragraph planning guide, which they then used to convert information into written expository paragraphs. All subjects reached instructional outcome criterion on the writing of comparison/contrast and sequence paragraphs. One week after reaching mastery in the special education classroom, students generalized their paragraph writing skills to other teachers and to different classrooms. The results of this investigation indicate that when provided with direct, intensive instruction in a text structure strategy, adolescents with learning disabilities can improve their skills in paragraph writing.