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C L Chronister

Publications and source records attributed to C L Chronister.

11 recordsLinked to original sources
PubMed2001

Possible iatrogenic transmission of Creutzfeldt-Jakob disease via tonometer tips: a review of the literature.

BACKGROUND: Tonometer tips are used by optometrists to measure intraocular pressures. The recommended procedure of soaking in bleach solution kills bacteria and certain viruses, such as human immunodeficiency virus, herpes simplex virus-1 and herpes simplex virus-2, adenovirus 8, and hepatitis B, from the tip. Conversely, recommendations made in literature to sterilize equipment that may have come in contact with virus-contaminated tissue from patients with Creutzfeldt-Jakob disease have a somewhat tougher requirement. METHODS: Autoclaving for 1 hour at a temperature of at least 120 degrees C (15 psi), or a 1-hour exposure to 0.5% sodium hypochlorite (a 10-fold dilution of household bleach) should provide excellent disinfection. One-hour exposure to 1 N Sodium hydroxide has also been mentioned in the literature. RESULTS: Studies have shown that corneas of guinea pigs with Cruetzfeldt-Jakob disease (C-J disease) are infectious. Infected corneas have been shown to cause transmission via corneal transplants, and via experimental placement of infected guinea pig's cornea into the anterior chamber of uninfected guinea pigs. Many researchers have strongly suggested that C-J disease can be iatrogenically transmitted via applanation tonometer tips. An epidemiologic case-controlled study found statistically significant odds ratio for intraocular pressure testing in the medical history of patients with C-J disease. CONCLUSION: Even though there have not been any proven studies confirming iatrogenic transmission through tonometer tips, optometrists should be cautious if a patient has C-J disease, or manifests symptoms of C-J disease and use alternatives to Goldmann applanation tonometry.

Animals↗
PubMed2000

Contact lens considerations for patients infected with HIV.

BACKGROUND: As an eye care practitioner, one must be aware of the many sequelae of HIV disease and its impact on contact lens patients. With the progressing development of anti-HIV medications, patients infected with HIV are living longer and more productive lives. Thus a greater number of patients infected with HIV may be candidates for contact lens wear. PURPOSE: The eye care practitioner will play an important role in caring for patients infected with HIV who wear contact lenses. Theoretically, contact lens wear in patients infected with HIV could potentially increase their risk of corneal infection particularly from opportunistic pathogens in immuno-compromised patents. METHODS: This article reviews the common anterior segment HIV-related complications that can impact on the ability to wear contact lenses. These complications include: keratoconjunctivitis sicca, herpes simplex, herpes zoster, microsporidial keratoconjunctivitis, molluscum contagiosum, bacterial keratitis, conjunctival microvasculopathy, and Kaposi's sarcoma. "In-office infection control" concerns will be reviewed, along with proper care and disinfection of contact lenses for patients infected with HIV.

AIDS-Related Opportunistic Infections↗
PubMed1999

Sarcoidosis-related anterior uveitis in a patient with human immunodeficiency virus.

BACKGROUND: This is the first ophthalmic report--to our knowledge--of an anterior uveitis secondary to sarcoidosis in a patient infected with human immunodeficiency virus (HIV). Other reported causes of uveitis in HIV-infected patients have included HIV, herpes zoster, tuberculosis, syphilis, toxoplasmosis, cryptococcus, rifabutin prophylaxis for mycobacterium, and protease inhibitors such as ritonavir and indinavir. Uveitis secondary to sarcoidosis in the non-HIV population is classically seen in young, female, African-American patients. There are rare reports, found exclusively in the pulmonary literature, of sarcoidosis in HIV-infected patients. CASE REPORT: A 38-year-old African-American male infected with HIV was treated for chronic recurrent anterior uveitis secondary to sarcoidosis. His sarcoidosis was diagnosed 1 month earlier, along with the onset of his uveitis. During the previous 6 years he has been treated with anti-HIV antivirals as well as prophylaxis for opportunistic infections. To date, his infectious disease specialist continues to treat his HIV and systemic sarcoidosis. CONCLUSION: Patients with HIV infection in whom sarcoidosis with secondary uveitis develops are very rare. Management of these patients requires careful use of topical and oral steroidal anti-inflammatories to control ocular and systemic sequelae of sarcoidosis. This case initiates some interesting questions about the immunology of sarcoidosis and its presence in immunocompromised patients. Use of steroids in an immunocompromised patient is clinically complex. Further clinical study is needed to elicit the full clinical significance of sarcoidosis and HIV infection.

Adult↗
PubMed1997

Structural damage to Schiotz tonometers after disinfection with solutions.

Although Schiotz tonometry has been long ago replaced by Goldmann applanation tonometry measurement of intraocular pressure, it remains a viable clinical technique in nursing homes and other "out of office" settings. Because Schiotz tonometers come into contact with the cornea and tear film, they must be properly disinfected to prevent cross-infection with HIV and other infectious pathogens. The Centers for Disease Control and Prevention (CDC) recommends that all eye contact devices be disinfected by a 5- to 10-min soak in one of following disinfectants: 3% hydrogen peroxide, 1:10 sodium hypochlorite (household bleach), or 70% isopropyl alcohol. The effects of these disinfectants on Schiotz tonometers have not been previously investigated. This study investigated the effects of CDC-recommended disinfectants on the structural integrity of Schiotz tonometers. The results of the study indicated that soaking in 1:10 sodium hypochlorite and 3% hydrogen peroxide damaged Schiotz tonometers and rendered them inoperable. Alcohol caused minor damage to the tonometer and was the safest of the CDC disinfectants. This study showed there is limited application of CDC infection control criteria to Schiotz tonometers due to the extensive corrosion and damage caused by hydrogen peroxide and bleach.

1-Propanol↗
PubMed1996

Review of external ocular disease associated with aids and HIV infection.

External ocular disease associated with human immunodeficiency virus (HIV) infection can often be overlooked by the eye care practitioner. Different types of external ocular disease can be an indication of the patient's overall immune status as well as the stage of HIV infection. The external ocular sequelae of HIV infection can be of visual consequence for the patient. Eye care practitioners need to become familiar with these conditions. The diagnosis and management of the following ocular conditions associated with HIV infection are reviewed: conjunctival microvascular disease, dry eye, allergic conjunctivitis, microsporidial keratoconjunctivitis, herpes zoster ophthalmicus, herpes simplex keratitis, molluscum contagiosum, fungal keratitis, bacterial keratoconjunctivitis, and Kaposi's sarcoma (KS).

AIDS-Related Opportunistic Infections↗
PubMed1995

Serologic confirmation of HIV infection.

As the number of patients with Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) increases, it is important for eye care practitioners to become familiar with the serologic testing used in testing for HIV infection. These tests include: HIV-ELISA (enzyme linked immunosorbent assay), HIV-Western Blot, PCR (polymerase chain reaction) gene amplification, p24 core antigen assay, Beta 2-microglobulin levels, and CD4 lymphocyte counts. This Symposium discusses the aforementioned serologic tests and their uses in the diagnosis and management of HIV infection.

AIDS Serodiagnosis↗
PubMed1994

Structural alteration of tonometer tips after repeated swabbing with disinfectants.

Our study was developed to measure the effect of swabbing on the integrity of Haag-Streit tonometer tips over time. The following solutions were used: hydrogen peroxide, dilute bleach, alcohol, phenol-phenate, and distilled water (as a control). The results show that swabbing causes surface scratching of tonometer tips after 1 year. The results also show that alcohol swabbing will lead to breakdown of the glue and warrant replacement of the tonometer tip after 2 years use.

Disinfectants↗
PubMed1992

Literature review of hepatitis B: should eye care practitioners receive a hepatitis B vaccine?

The incidence of Hepatitis B infection has been steadily increasing over the last 5 years. The current literature has established that eye care practitioners are in the high risk category for contracting and transmitting this serious viral infection. Hepatitis B Virus (HBV) is present in all bodily fluids including tears and is considered to be more easily transmitted with a higher degree of infectiousness than Human Immunodeficiency Virus (HIV). Fortunately, unlike Acquired Immune Deficiency Syndrome (AIDS), hepatitis can be prevented with a vaccine. Recent improvements in the hepatitis vaccine have made it safer and more effective. As optometrists expand their scope of practice, it becomes essential to increase the knowledge base and awareness of this clinical entity so informed decisions can be made regarding vaccination by eye care practitioners, teaching faculty, and students.

Hepatitis Antibodies↗
PubMed1991

Congenital retinal macrovessel.

Congenital retinal macrovessel is a rare condition in which anomalous retinal vessels cross the macula. Visual impairment can result if the anomalous vessels pass across the foveola, if foveolar cysts form, or if hemorrhage occurs. A now 17-year-old African-American female has an anomalous retinal vein that crossed the macular region beyond the horizontal raphe in her left eye. This patient exhibited the classic characteristics of congenital macrovessels. Her visual acuity remained unaffected after a 5-year follow-up and therefore treatment was not required.

Adolescent↗
PubMed1990

Effects of disinfecting solutions on tonometer tips.

We investigated the effects of selected disinfecting solutions on the structural integrity of Goldmann applanation tonometer tips. Hydrogen peroxide, isopropyl alcohol, dilute sodium hypochlorite (household bleach), and glutaraldehyde-phenate (Sporicidin) have been used for disinfecting tonometer tips. However, the effect of these solutions on the tips' structure has not been fully investigated. Haag-Steit tonometer tips were soaked separately for 30 days (723 h) in 5 different solutions and distilled water, approximately 1 working year of routine use (310 days by 14 patients per day). During the soaking period, the tips were regularly removed from solution, examined through a slitlamp, measured with vernier calipers, and photographed to monitor for structural degradation. Alcohol was the only solution that damaged the tips. The other disinfecting solutions appear to be safe for use on the tips after the equivalent of 1 working year of routine use.

1-Propanol↗