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Biomedical subjects

H B Ostler

Publications and source records attributed to H B Ostler.

At least 19 recordsLinked to original sources

Fuchs' superficial marginal keratitis.

We studied three cases of Fuchs' superficial marginal keratitis, an uncommon condition that is characterized by intermittent, recurrent episodes of ocular irritation accompanied by marginal infiltrates and that is followed by progressive marginal superficial stromal thinning. Usually, it has an indolent course with spontaneous remission, and good visual acuity is preserved. In advanced cases, a pseudopterygium develops in the area of marginal thinning. The pseudopterygium encroaches onto the cornea over a period of years, but spares the central cornea. In two of our three cases, the degree of thinning beneath the pseudopterygium became marked. This led to corneal perforation during pseudopterygium excision in one case, and after blunt trauma in the other. These complications indicate the need for special precautions when caring for these patients.

Adult

Alteration of human conjunctival epithelial proliferation.

We used in vitro bromodeoxyuridine to analyze the labeling indexes of conjunctival cells in several external eye diseases. Patients with superior limbic keratoconjunctivitis, squamous cell carcinoma of the conjunctiva, drug-induced pseudopemphigoid, and Stevens-Johnson syndrome had increased conjunctival DNA synthesis.

Bromodeoxyuridine

Chronic anterior uveitis in leprosy: an insidious cause of blindness.

Chronic low grade anterior uveitis is the commonest cause of blindness in leprosy. It is usually asymptomatic until the late stages, and often patients seek help only after irreversible visual impairment has occurred. We present herewith several cases of this entity to emphasise the insidious nature of the disease, the extent of ocular damage it can cause, and the importance of early detection and treatment.

Adult

Treatment of ocular disease in eczema herpeticum.

Individuals with atopic dermatitis are particularly susceptible to herpes simplex viral infection and may develop dissemination (eczema herpeticum). Additionally, they may develop severe and bilateral herpetic ocular disease. The keratitis is commonly complicated by stromal scarring and slow epithelial healing despite topical antiviral therapy. We treated three patients who had herpetic keratoconjunctivitis associated with eczema herpeticum. In all three cases the keratitis resolved promptly (48 to 72 hours) without residual scarring after treatment with systemic acyclovir and topical trifluridine. The combined use of systemic acyclovir and topical trifluridine may be of similar value in treating all cases of atopic herpetic keratitis.

Acyclovir

Hansen's disease.

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Developing Countries

Intraocular pressure and iris denervation in Hansen's disease.

We retrospectively analyzed 255 Hansen's disease patients and found low intraocular pressure (less than 7 mm Hg) in 12% of them. We showed a correlation between low intraocular pressure and avascular keratitis and iritis. We also found that patients with low intraocular pressures had abnormally large postural changes in intraocular pressure. We speculate that abnormalities in the autonomic innervation of the anterior segment of the eye may be related to the intraocular pressure abnormalities. Further investigations along this line may increase our understanding not only of the pathophysiology of Hansen's disease but also of the mechanisms regulating homeostasis of intraocular pressure.

Autonomic Nervous System

Low intraocular pressure and postural changes in intraocular pressure in patients with Hansen's disease.

We found intraocular pressures of less than 7 mm Hg in 11 of 72 patients (15%) with early Hansen's disease. Furthermore, significant postural changes in intraocular pressure (greater than 30%) occurred in 43 of 72 patients (60%). This loss of intraocular pressure homeostasis, which results from reduced aqueous humor production or increased uveoscleral outflow with reduced local adrenergic control in the ciliary body-iris-trabecular meshwork region, suggests that early autonomic neuropathy of the eye may occur in Hansen's disease. The only predictive value for significant postural change in intraocular pressure was the presence of immunologically unstable disease.

Homeostasis

Thygeson's superficial punctate keratitis.

Thygeson's superficial keratitis is a chronic disease of the cornea characterized by focal epithelial lesions. We studied 45 cases of Thygeson's superficial punctate keratitis. Twenty-eight were male and 17 were female patients. The disease had been active in our patients from one month to 24 years. The clinical findings, course, outcome, and response to therapy were studied. Viral cultures and microscopic studies were performed on the corneal epithelial scrapings from ten cases. The average course of the disease was prolonged in patients who received topical steroid therapy. Subepithelial opacities were seen more frequently in patients who had received treatment with idoxuridine (IDU).

Adolescent