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PubMed2004

A three-way comparative study on the efficacy of twin sol to gel systems and marketed eye drops of pefloxacin mesylate.

The authors compare the efficacy of sol to gel systems and marketed eye drops of Pefloxacin mesylate (PM) in the patients with bacterial conjunctivitis. It was an open, comparative, 3-treatment, randomized, parallel study. Formulations were tested on 15 patients with bacterial conjunctivitis. Each formulation was tested on 5 patients. Patients receiving marketed eye drops were instructed to use 2 drops, 4 times a day for 7 days. Patients receiving sol to gel were instructed to use 1 drop every 12 hours for 7 days. Pharmacodynamic parameters, based on a scale of rating, were used to assess the improvement in conjunctivitis on treatment with formulations. Conjunctival swabs were taken from eyes of patients, and viable counts were performed at days 0, 3, 5, and 7. Statistical analysis of the pharmacodynamic data indicated that both sol to gel systems used were more effective than marketed eye drops in the treatment of bacterial conjunctivitis. Results of the viable count revealed that a faster reduction in the number of colony-forming units (cfu) were obtained with both sol to gel systems, compared to marketed eye drops. It can be concluded that both sol to gel systems were superior to marketed eye drops in the treatment of bacterial conjunctivitis.

Analysis of Variance↗
PubMed2003

[Clinical efficacy of ciprofloxacin 0.3%9 (Ciloxan) in the treatment of bacterial infections of the external eye segment].

PURPOSE: The main subject of the study was to evaluate efficacy of ciprofloxacin 0.3% ophthalmic solution (Ciloxan) in the treatment of bacterial conjunctivitis and surgical prophylaxis. Safety and comfort of topical ciprofloxacin treatment was also examined. MATERIAL AND METHODS: Two study arms: 99 patients with bacterial conjunctivitis (A group) and 48 patients awaiting cataract surgery (B group--total 147 subjects in both groups) received ciprofloxacin 0.3% ophthalmic solution (Ciloxan) 4 doses a day for seven days. Bacteriological evaluation was established before and after treatment for each eye. RESULTS: 95 out of the 99 patients (96%) in the first arm were completely cured (all signs and symptoms of the bacterial conjunctivitis were eliminated). In the second arm complete eradication of bacterial flora was achieved in 46 out of 48 pretreated patients (96%). CONCLUSIONS: Topical ciprofloxacin 0.3% (iloxan) was found very effective and fast in reduction of typical signs and symptoms of bacterial conjunctivitis as well as in eradication of bacterial flora before surgery treatment.

Adolescent↗
PubMed1998

Conjunctival dermoid cyst seen on examination as a chronically red eye.

We describe a patient who was seen with a unilateral red eye and purulent discharge refractory to antibiotic treatment with multiple antibiotic regimens over the previous 4 months. Initially it was believed to be a bacterial conjunctivitis, but when conventional treatments failed it was thought to be a viral conjunctivitis with bacterial superinfection. Cultures yielded only Enterococcus. There was a small mass with a draining fistulous tract at the lateral canthus. Symptoms persisted despite courses of topical and systemic antibiotics followed by a tapering dose of steroids. The patient was taken to the operating room for an orbitotomy through the conjunctiva at the lateral canthus. Findings from pathologic examination of the excised mass demonstrated a dermoid cyst of the conjunctiva. This clinical appearance obscured the diagnosis.

Adult↗
PubMed2004

Prevalence of non-vision-impairing conditions in a village in Chakwal district, Punjab, Pakistan.

PURPOSE: To determine the prevalence of non-vision-impairing ocular conditions (NVIC) and estimate the number of primary eye care treatments per 1000 population per month. METHODS: A cross-sectional study in a random sample of 1670 people was done to determine the load of NVIC in a village in Chakwal district. RESULTS: The prevalence of NVIC was 30.6% (306 per 1000 population). NVIC with the exclusion of presbyopia accounted for 14.6%. The main NVIC were allergic conjunctivitis (3.7%), bacterial conjunctivitis (3.5%), pterygium/pinguicula (2.6%) and acute/chronic dacryocystitis (1%). The average Complaint Frequency (CF) per month/1000 population was 55, excluding complaints of near vision and watery eyes. CONCLUSIONS: The foundation of a comprehensive district eye care strategy in the light of VISION 2020 - the Right to Sight - remains an effective primary eye care service whose elements are treatment of NVIC, detection and referral of cataracts and refractive errors, and promotion of eye health.

Adolescent↗
PubMed1979

Immunoglobulin concentrations in human tears in ocular diseases.

Immunoglobulin concentrations in human tears were determined in 165 patients with different eye diseases by a standard radial immunodiffusion method. IgA was present in all the samples in measurable quantity. The mean IgA values were significantly higher than the controls in patients with acute bacterial conjunctivitis, keratomalacia, corneal graft reaction, blepharoconjunctivitis, and acute keratoconjunctivitis. The values in the patients with vernal conjunctivitis, phlyctenular conjunctivitis, acute bacterial corneal ulcer, and acute endogenous uveitis were not significantly different from those in the controls. IgG could be detected in the majority of the samples but it was in measurable quantity in 18 samples. IgM could be detected in fewer samples. IgD was not detected in any of them. The study indicates that, whenever the immunoglobulin levels in tears are altered in diseased eyes, it is the IgA level that is predominantly altered and not the IgG level.

Adolescent↗
PubMed1988

How do general practitioners manage eye disease in the community?

A survey of the management of eye disease in the community was carried out in two general practices over a three-month period. During this time there were 238 consultations by patients with ocular symptoms, making up 2.3% of all consultations and giving an annual consultation rate for eye disease of 66 per 1000 persons at risk. The four commonest diagnoses were bacterial conjunctivitis, allergic conjunctivitis, meibomian cyst, and blepharitis, and these accounted for more than 70% of the consultations. A variety of topical and systemic treatments were used, with topical chloramphenicol prescribed in 55% of consultations. Referral to a hospital eye department resulted from 35 consultations, giving a referral rate of 15% of all consultations.

Adolescent↗
PubMed2002

Ocular applications of povidone-iodine.

Ocular infections can have devastating consequences and may lead to blindness. Povidone-iodine (PVP-I) has many potential advantages over the currently used drugs, including a broader antibacterial spectrum, it turns the surface of the eye brown for a few minutes, bacterial resistance has not been seen and it is cheaper than other agents. PVP-I has made a significant contribution to pre- and postoperative ocular surgical prophylaxis, ophthalmia neonatorum prophylaxis and treatment of bacterial conjunctivitis. Scientific support for these applications includes studies conducted over the past 17 years, which are reviewed.

Adult↗
PubMed2006

Enhanced release of IL-6 and IL-8 into tears in various anterior segment eye diseases.

OBJECTIVE: To determine the levels of interleukin 6 (IL-6) and interleukin 8 (IL-8/CXCL-8) in tears collected from the eyes of normal individuals and of patients with different irritative eye diseases, in order to acquire information on the immunological changes occurring during the early postoperative period following various forms of eye surgery, including penetrating keratoplasty (PKP). METHODS: IL-6 and IL-8 levels were measured with the aid of human ultrasensitive ELISA kits in the non-stimulated tears of patients in the early postoperative period following PKP or cataract operation, and of patients with acute bacterial conjunctivitis or with a corneal foreign body. The IL-6 and IL-8 concentrations, the total amounts released in a given time and the rates of their release were calculated. RESULTS: A significant increase in IL-6 release was observed in all patient groups compared with the normal controls (p < or = 0.003). The IL-8 release levels were significantly higher in the tears of all patient groups (p < or = 0.03), except for the cataract operation group, where the IL-8 release was not significantly higher (p = 0.053) than in the control samples. No significant differences in IL-6 or IL-8 release were observed when the various patient groups were compared with each other. CONCLUSION: The release of IL-6 and IL-8 into the tears is enhanced in various anterior segment eye diseases, and this may be used as an indicator of various inflammatory reactions in the early postoperative period.

Adolescent↗
PubMed1991

Bioactive polymers 54. Pharmacological properties of modified neomycin.

Modified neomycin prepared by the ionic coupling on xanthan with an activity of 380 UI/mg was characterized in regard to its in vitro and in vivo release rate and therapeutic action with artificial tear eluent. The dynamic system in vitro release showed that after 4 h, there appears a "zero-order" kinetic. Ophthalmic inserts were prepared from modified neomycin and they are used in treating bacterial conjunctivitis. Sterilization of the conjunctival sac is obtained 12 h after insert administration.

Conjunctivitis, Bacterial↗
PubMedDate not supplied

Comparative evaluation of efficacy and safety of ciprofloxacin and norfloxacin ophthalmic solutions.

The efficacy and safety of ciprofloxacin ophthalmic solution 0.3% and norfloxacin ophthalmic solution 0.3% in the treatment of bacterial conjunctivitis and blepharitis were compared in a double masked randomised study. A total of 131 patients, 65 treated with ciprofloxacin (42 with conjunctivitis and 23 with blepharitis) and 66 treated with norfloxacin (39 with conjunctivitis and 27 with blepharitis) were enrolled in the study at five centres in France. In the efficacy population, pathogens were eradicated or reduced in 96% (24/25) of patients in the ciprofloxacin group and 89% (24/27) in the norfloxacin group. There was no difference between treatments with regard to eradication of particular pathogens. In the efficacy population, clinical cure or improvement was seen in 96% of the patients (24/25 in the ciprofloxacin group and 26/27 in the norfloxacin group). There were no significant differences between ciprofloxacin and norfloxacin with respect to improvements in four symptoms or ten clinical signs. No serious treatment-related adverse events were reported and both ciprofloxacin and norfloxacin were well tolerated.

Anti-Infective Agents↗
PubMed1982

Immunoassay of tear lysozyme in conjunctival diseases.

The tear lysozyme content in 111 normal subjects and in 159 patients with various conjunctival diseases was determined by a single radial immunodiffusion technique. Tear lysozyme level in normal people was 1.33/mg/ml. (SI conversion: mg/ml = g/l.) The mean tear lysozyme levels in patients with chronic irritative conjunctivitis (0.97 mg/ml) and nutritional deficiency with epithelial xerosis (0.76 mg/ml) were significantly lower than in the normal controls. The mean tear lysozyme levels in tears from patients with vernal conjuctivitis (1.20 mg/ml), phlyctenular conjunctivitis (1.10 mg/ml), and acute bacterial conjunctivitis (1.48 mg/ml) were not significantly different from those in the normal controls. Superimposition of acute bacterial conjunctivitis on trachoma did not alter the low tear lysozyme level that existed before in these patients.

Adolescent↗
PubMed1993

The bacterial etiology of conjunctivitis in early infancy. Eye Prophylaxis Study Group.

The authors conducted this study to determine the etiologic agents of conjunctivitis in early infancy. From 1985 to 1990, 630 infants enrolled in a randomized, controlled, double-masked study of eye prophylaxis were observed for 60 days after delivery for signs of conjunctivitis. The following isolates were categorized as pathogens: Haemophilus influenzae, Streptococcus pneumoniae, Neisseria cinerea, Klebsiella pneumoniae, and Chlamydia trachomatis. Using conditional logistic regression for analysis of 97 infant pairs, the authors identified isolates categorized as pathogens almost exclusively among cases (odds ratio (OR) = 18.0, 95% confidence interval (CI) 2.3-128). Among the microorganisms which have not usually been regarded as pathogens in the etiology of infant conjunctivitis, Streptococcus mitis was the only microorganism associated with an increased risk of conjunctivitis (OR = 5.3, 95% CI 1.8-15.0). The findings concerning the species of bacteria most often associated with conjunctivitis, as well as the finding that method of delivery is unimportant, suggest that bacteria were transmitted to the infants' eyes after birth and not from the birth canal.

Adult↗
PubMed1984

Efficacy of topical antibiotic therapy in acute conjunctivitis in children.

We studied 102 children aged 1 month to 18 years in a randomized, double-blind trial designed to determine both the natural history of bacterial conjunctivitis and whether topical antibiotic therapy is beneficial. Affected eyes were treated four times a day for 7 days with drug (polymyxin-bacitracin ophthalmic ointment) or placebo. Eighty-four patients had proved bacterial conjunctivitis (Haemophilus influenzae 61, Streptococcus pneumoniae 22, both one); 66 of these received only topical therapy. By 3 to 5 days, 21 of 34 (62%) patients receiving topical antibiotic were clinically cured, whereas only nine of 32 (28%) patients given placebo were cured (P less than 0.02). By 8 to 10 days, 31 (91%) of the patients given antibiotic and 23 (72%) of the placebo group were cured (P = NS). The bacterial pathogen was eradicated by day 3 to 5 in 71% and by day 8 to 10 in 79% of patients given antibiotic, compared to 19% and 31% of the placebo group (P less than 0.001). Acute bacterial conjunctivitis is a self-limited disease, but topical antibiotic therapy with polymyxin-bacitracin shortens the duration of clinical disease and enhances eradication of the causative organism from the conjunctiva.

Acute Disease↗
PubMed1996

[Primary meningococcal conjunctivitis: implications beyond the conjunctiva].

BACKGROUND: Neisseria meningitidis is a uncommon cause of acute bacterial conjunctivitis. However, its diagnosis has important therapeutic implications. METHODS: From December 1993 to January 1984, a prospective study on acute bacterial conjunctivitis was performed at the Hospital Universitario Materno-Infantil Vall d'Hebron. Primary meningococcal conjunctivitis (PMC) was diagnosed in 34 patients. The diagnosis of PMC was made on the basis of consistent clinical manifestations together with isolation of Neisseria meningitidis from conjunctival exudate culture. RESULTS: There were 16 men and 18 women with a mean age of 3.5 +/- 3.3 years. PMC was bilateral in 7 patients and unilateral in 27. Initial therapy for PMC included only topical antibiotics in 24 patients and systemic antibiotic therapy in 10. Ten patients (29.4%) developed invasive meningococcal disease. None of the patients died neither developed ocular sequelae. Forty one percent of the patients who received only topical therapy and none [corrected] of those who received systemic therapy, developed invasive meningococcal disease (p = 0.04). CONCLUSIONS: PMC may represent the portal of entry for invasive meningococcal disease, which occurs in almost a third of patients. Patients with PMC and higher risk of developing invasive meningococcal disease are those treated only with topical antibiotic therapy.

Acute Disease↗
PubMedDate not supplied

Ion-activated, Gelrite-based in situ ophthalmic gels of pefloxacin mesylate: comparison with conventional eye drops.

The purpose of our work was to develop an ophthalmic delivery system of a flouroquinolone antibiotic, pefloxacin mesylate, based on the concept of ion-activated in situ gelation. Gelrite gellan gum, a novel ophthalmic vehicle, that gels in the presence of mono- or divalent-cations present in the lacrimal fluid, was used as the gelling agent. The developed formulation was compared with marketed eye drops in efficacy of treatment of bacterial conjunctivitis that was induced artificially in rabbits. The formulations were evaluated for rheological characteristics, in vitro release behavior, antimicrobial efficacy, and efficacy against bacterial conjunctivitis. We found that in situ gelling formulations passed the test for sterility. The formulations exhibited a first-order release pattern over 12 hr in in vitro release studies. The developed formulation was effective against selected micro-organisms in antimicrobial efficacy studies. The shelf lives of formulation was >2 years. The formulation demonstrated better therapeutic efficacy compared with standard eye drops because it improved the clinical parameters monitored for prolonged periods. The developed formulations can be considered as a viable alternative to conventional eye drops.

Animals↗
PubMedDate not supplied

A review of the causes and treatment of bacterial and allergic conjunctivitis.

The most common causes of ocular inflammation are allergic or infectious in origin. A presumptive diagnosis can often be made through a comprehensive patient history and evaluation of presenting signs and symptoms, although the constellation and intensity of clinical findings may vary. Patients with allergic conjunctivitis often have itchy, red eyes, whereas patients with bacterial conjunctivitis often give a history of morning crusting and difficulty opening the eyelids. The treatment of patients with allergic conjunctivitis includes avoiding the offending allergen and applying topical antihistamines, mast cell stabilizers, or nonsteroidal anti-inflammatory agents. Streptococcus pneumoniae and Haemophilus influenzae are responsible for most cases of bacterial conjunctivitis in children. Staphylococcus species is the predominant organism in adults. Therefore, the treatment of patients with bacterial conjunctivitis consists of an antimicrobial agent with a broad spectrum of activity against most susceptible pathogens. Other causes of inflammation need to be considered in patients with atypical clinical signs and symptoms and in patients who do not respond to presumptive therapy.

Adult↗