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PubMed1999

[The value of the cytological exam in the diagnosis of allergic conjunctivitis].

Cytologic investigations was performed in four groups of patients: central group (10 cares), without pathologic lesions; 12 patients were admitted with allergic conjunctivitis (with positive allergy tests, atopic state or clinical manifest allergic diseases), 20 cases with bacterial conjunctivitis; 8 cases with mix allergic and bacterial conjunctivitis (that hardly respond to therapy). Smears from the conjunctivae secretion were air-dried and stained with blue-polycrometanin Drăgan method. Cytologic lesions characteristic for each group of patients are described. Our results suggest that cytology from the conjunctivae secretion is helpful in the diagnosis of the allergic etiology; also, it accurately the allergic components mix conjunctivitis.

Acute Disease↗
PubMedDate not supplied

Fusidic acid in infections of the external eye.

A newly developed 1% eye preparation of the potent antistaphylococcal antibiotic fusidic acid, showed an excellent clinical effect in 206 Egyptian children with external eye infections. The 248 patients included in the study were randomized, in the ratio 5:1, to either fusidic acid or chloramphenicol 0.5% eye drops. Both preparations were given four to six times daily for one week. Bacterial conjunctivitis was diagnosed in 56% of the children. Offending eye pathogens were mainly Staphylococcus aureus (60%), Haemophilus aegyptius (10%), Streptococcus pneumoniae (13%) and Neisseria gonorrhoeae (6%). The overall clinical success rate in children with bacterial conjunctivitis was 85% with fusidic acid, compared to 48% with chloramphenicol (p less than 0.001). The better effect of fusidic acid could be ascribed to a lower frequency of in vitro resistance (16%) in comparison to chloramphenicol (55%). Both drugs were apparently well tolerated and no side-effects were observed.

Adolescent↗
PubMedDate not supplied

[Keratomalacia in rheumatoid arthritis: immunohistologic and enzyme histochemical studies].

Corneal and conjunctival biopsies of 13 patients with rheumatoid arthritis and corneal ulceration (RA-keratomalacia) have been characterized by immunohistological and histochemical analysis. Biopsies from 13 patients with bacterial conjunctivitis, 7 patients with allergic conjunctivitis, 15 patients with senile cataract and 15 patients with keratokonus served as controls. The phenotypic composition of the conjunctival inflammatory infiltration of rheumatoid corneal ulceration was not significantly different from the other inflammatory eye diseases studied. However, conjunctival epithelial cells of all RA-patients showed strong de novo expression of HLA-DR- and DP-antigens. HLA-DQ-antigens were only weakly expressed in a minority of patients. In bacterial conjunctivitis a less intense HLA-class-II-expression was found to be restricted to HLA-DR-antigens. Furthermore, in RA patients stromal fibroblasts of the cornea expressed lysosomal elastase. Both observations could be explained by paracrine action of interleukins produced by infiltrating T-lymphocytes and macrophages. Thus, it might be tempting to speculate that immunologically induced, elastase mediated autodegradation of corneal stroma may be an important factor in the pathogenesis of rheumatoid corneal ulceration.

Antigens, Differentiation, T-Lymphocyte↗
PubMed2003

Ophthalmic delivery of ciprofloxacin hydrochloride from different polymer formulations: in vitro and in vivo studies.

Reservoir-type ocular inserts were fabricated using sodium alginate containing ciprofloxacin hydrochloride as the core (drug reservoir) that was sandwiched between the Eudragit and/or polyvinylacetate films. Ocular inserts were packaged in aluminium foil and sterilized by gamma radiation. These were tested for sterility as per British Pharmacopoeia (BP). Ocular inserts were evaluated for in vitro release rate studies, microbial efficacy, in vivo release studies, efficacy against induced bacterial conjunctivitis in rabbit's eyes, concentration in the aqueous humor, and stability studies as per the International Conference on Harmonization (ICH) guidelines. Ocular inserts passed the test for sterility. They showed zero-order release of the drug in the in vitro and in vivo release studies over a period of 120 hr. The drug was found to be active against selected microorganisms as was proved by microbial efficacy studies. A high correlation coefficient was found between in vitro and in vivo release rate studies. Better improvement was observed in artificially induced bacterial conjunctivitis in rabbit's eyes, compared with marketed eye drops and placebo. Drug concentration in the aqueous humor was found above Minimum Inhibitory Concentration (MIC-90) against selected microorganisms. Shelf-life of the product was found to be more than 2 years.

Administration, Topical↗
PubMed2004

Ciprofloxacin as treatment for conjunctivitis.

The authors studied the bactericidal action and therapeutic effectiveness of ciprofloxacin in treating external ocular infections (bacterial conjunctivitis and bacterial blepharoconjunctivitis). 108 ambulatory patients with clinical signs of conjunctivitis and blepharoconjunctivitis were enrolled in the study. All subjects underwent a conjunctival swab before starting therapy and at 10 days, to identify the causative bacteria and their susceptibility to ciprofloxacin, following routine microbiological methods. The reported therapeutic success rate (95%) and bacteriological analysis confirmed the effectiveness of ciprofloxacin in subjects with bacterial conjunctivitis and bacterial blepharoconjunctivitis. In vitro tests conducted 10 days after treatment confirmed the in vivo therapeutic effectiveness, even for those infections characterized by a difficult etiological identification which interferes with specific antibiotic therapy.

Administration, Topical↗
PubMedDate not supplied

Ciprofloxacin ophthalmic solution versus rifamycin ophthalmic solution for the treatment of conjunctivitis and blepharitis.

The efficacy and safety of ciprofloxacin (0.3%) ophthalmic solution and rifamycin (1%) ophthalmic solution for the treatment of bacterial conjunctivitis and blepharitis was compared in this randomized, double-masked, parallel-group study. Forty-one patients, 19 on ciprofloxacin and 22 on rifamycin, were culture-positive on admission and evaluated for efficacy. There was clinical improvement in more than 90% of patients in each group at the end of the seven-day treatment period. However, clinical cure rates on day 7 appeared to be higher with ciprofloxacin (53%) than rifamycin (23%; p = 0.061, Mann-Whitney test). Bacteriological eradication rates were comparable: the infecting organisms were eradicated in 68% of patients on ciprofloxacin and 77% with rifamycin. There were no serious adverse reactions to either treatment. One patient in each group was withdrawn on account of a mild allergy. In conclusion, topical ciprofloxacin was effective and well tolerated and would be a particularly useful agent for the treatment of bacterial conjunctivitis and blepharitis.

Acute Disease↗
PubMed1993

Antiseptics versus antibiotics in the treatment of the experimental conjunctivitis caused by Staphylococcus aureus.

To evaluate the effect of some antiseptics, which have fewer side effects than antibiotics, an experimental model of bacterial conjunctivitis in vivo was used. This model imitates traumatic Staphylococcus aureus conjunctivitis in the rabbit. At 48 h after infection, polyvinylpyrrolidine (PVP)-iodine, bibrocathol (Noviform, NF), ethacridine (Biseptol, BS) and bacitracin+polymyxin B+neomycin (Polyspectran, PS) were applied. NaCl served as the control. At days 2, 5, 8, 11 and 14 a photographic documentation was done, and a swab was taken every 2nd day. In achieving regression of hyperemia, the substance tested were ranked in the following order: PVP, NF, BS, PS, and NaCl. In the elimination of S. aureus, the ranking order was BS, PVP, PS, NaCl, and NF. The overall ranking was PVP, BS, PS, NF, and NaCl. However, the differences were not significant. In this standardized in vivo model of bacterial conjunctivitis, antiseptics are superior over an antibiotic in accomplishing regression of hyperemia and germ elimination.

Animals↗
PubMed2006

Fusidic acid viscous eyedrops--an evaluation of pharmacodynamics, pharmacokinetics and clinical use for UK optometrists.

Recent changes in UK law have allowed UK-based optometrists to sell and supply fusidic acid viscous eyedrops, providing it is in the course of their professional activity and in an emergency. Alternatively, the optometrist may access fusidic acid viscous eyedrops, for a named patient, using a written order supplied to a pharmacy. This review provides details of the legal background to these changes, examines the common causes of a bacterial conjunctivitis, examines the mechanism of action of this narrow spectrum antibiotic as a bacteriostatic agent, reviews the susceptibility of common ocular isolates of bacteria to the drug and presents details of the expected pharmacokinetics of the viscous eyedrops. From this perspective, a systematic review is provided of the clinical studies which have investigated the use of fusidic acid viscous eyedrops and their outcome. The indicated use is generally for the treatment of bacterial conjunctivitis and/or blepharoconjunctivitis, especially that caused by Staphylococcus, but not Streptococcus or Haemophilus sp. (more likely associated with concurrent nasopharyngeal infections). The usual regimen for use is twice daily for 5-10 days, depending on severity, and can initially be used more intensively (four times per day). It may also be used for the management of corneal and conjunctival abrasions and foreign body injuries, or some cases of chronic blepharitis.

Administration, Topical↗
PubMed1988

Safety and efficacy of topical norfloxacin versus tobramycin in the treatment of external ocular infections.

Bacterial conjunctivitis appears to resolve more rapidly when treated with appropriate topical antimicrobial agents. In this multicenter, randomized, double-blind study of efficacy and safety, patients with presumed bacterial external eye infections were assigned to topical therapy with 0.3% norfloxacin or 0.3% tobramycin. A total of 120 patients were enrolled. Of the total, 65 had documented bacterial infections and were evaluable; 59 of these patients had bacterial conjunctivitis. All of the patients with documented infections were cured or improved regardless of the drug treatment regimen or in vitro susceptibility testing results. The most common bacteria isolated were Haemophilus influenzae, Streptococcus pneumoniae, alpha-hemolytic streptococci, Staphylococcus aureus, and Staphylococcus sp. No patients had serious adverse reactions attributed to their therapy. Norfloxacin ophthalmic solution seems to be a safe, effective, and appropriate agent for the treatment of bacterial external eye infections.

Administration, Topical↗
PubMedDate not supplied

Ciprofloxacin ophthalmic solution in the treatment of conjunctivitis and blepharitis: a comparison with fusidic acid.

The efficacy and safety of ciprofloxacin ophthalmic solution (0.3%) and fusidic acid gel (1%) were compared in the treatment of bacterial conjunctivitis and blepharitis in a randomized, open, parallel group study. Thirty-nine patients, 21 treated with ciprofloxacin solution and 18 treated with fusidic acid gel, were culture-positive on admission and were evaluable for efficacy. At the end of a 7-day treatment, the infecting organism was eradicated in 81% of those treated with ciprofloxacin and 72% of those treated with fusidic acid gel. There was clinical cure or improvement in 95% and 89% respectively. The clinical cure rate appeared to be higher with ciprofloxacin than fusidic acid (62% compared with 28%) but this was related to the higher proportion of patients with acute conjunctivitis in the ciprofloxacin group. Two patients using ciprofloxacin had mild discomfort and stinging on instillation and one given fusidic acid had moderate edema and discomfort; the latter patient stopped treatment. Topical ciprofloxacin is effective and well tolerated and is a useful treatment of bacterial conjunctivitis and blepharitis.

Adolescent↗
PubMed1977

Trachoma in Punjab: a study of the prevalence and of mass treatment.

During the years 1971-1974 the prevalence of trachoma in the state of Punjab/Northwest-India was investigated among 11,172 persons of all age-groups. The overall prevalence came to 71,07%. Active and progressive stages (WHO stages I and II) were most common among children and adolescents, whereas complicated cases (WHO stage IV) were found predominantly beyond 45 years of age. Regressive cases (WHO stage III) were equally distributed throughout all ages. To our opinion bacterial conjunctivitis is an important factor preceding the infection with the TRIC-agent. Bacterial conjunctivitis is favoured by adverse climatic conditions (duststorms). A masstreatment using local sulfacetamide was started among 4500 children with trachoma, 1966 children could be seen after 6 months. The incidence of trachoma had dropped to 30%. For mass-treatment in a developing country topical application of antibiotics or sulfas seems advisable. Still more important is health-education, which at the moment is lacking everywhere.

Adolescent↗
PubMed1995

Use of eyepatches in phototherapy: effects on conjunctival bacterial pathogens and conjunctivitis.

We conducted a randomized controlled trial to determine the effects of eye occlusion on the risk of eye infection in full term newborn infants receiving phototherapy. Among 102 infants whose eyes were occluded with eyepatches, pathogens were isolated from 50 eyes of 33 infants. The positive isolation rate was significantly higher than that of a group of control infants (n = 101) whose eyes were protected by a headbox made of light-proof plastics. Among the latter group pathogens were detected in 22 eyes of 14 infants. In addition significantly more infants in the eyepatches group had purulent eye discharge (23 of 102 vs. 9 of 101, P = 0.013) and clinical conjunctivitis (13 of 102 vs. 2 of 101, P = 0.004) than the controls. Proper eye care is imperative when eyepatches are used on infants receiving phototherapy, and alternative methods of eye protection should be considered.

Bacteria↗
PubMed2000

Tolerance of N-chlorotaurine, a new antimicrobial agent, in infectious conjunctivitis - a phase II pilot study.

N-Chlorotaurine (NCT) is an endogenous microbicidal oxidant. This open pilot study (phase IIa) with 9 patients was done to gain first knowledge on the tolerance of NCT in infectious conjunctivitis. By application of 1% NCT 5 times a day, no adverse effects could be observed. All 6 subjects with bacterial conjunctivitis were cured within 3-5 days. Two subjects with epidemic keratoconjunctivitis were treated for 7-10 days and 1 subject with herpes simplex blepharitis for 3 days with no rapid improvement but probable mitigation of inflammation. Therefore, NCT seems to be useful in the treatment of infectious conjunctivitis, and further investigation on its therapeutic efficacy is suggested.

Adolescent↗
PubMed2006

Ocular findings in Japanese children with nephrotic syndrome receiving prolonged corticosteroid therapy.

OBJECTIVE: To examine ocular findings in Japanese children with nephrotic syndrome who receive prolonged corticosteroid treatment. METHODS: Information was retrospectively obtained from each patient's record. RESULTS: A total of 45 children (30 boys and 15 girls) were enrolled. Twenty-one patients (46.7%) had epiblepharon with inverted eyelashes. The incidence of epiblepharon was associated with overweight and obesity. Fifteen patients (33.3%) developed posterior subcapsular cataract in both eyes. Of the 15 patients, 4 had visual acuity less than 0.4 and underwent cataract extraction in both eyes. Nine patients (20%) developed intraocular pressure higher than 22 mm Hg during corticosteroid treatment. The total dose and duration of corticosteroid treatment were associated with cataract formation but were unassociated with elevated intraocular pressure. One boy had elevated intraocular pressure after cessation of corticosteroid therapy and underwent trabeculectomy. One patient had repeated hordeolum in the left eyelid. Three patients had bilateral bacterial conjunctivitis. CONCLUSION: Children with nephrotic syndrome who receive corticosteroid treatment may have epiblepharon, cataract, ocular hypertension, hordeolum and bacterial conjunctivitis.

Adolescent↗
PubMed1986

Assessment of neonatal conjunctivitis with a direct immunofluorescent monoclonal antibody stain for Chlamydia.

Chlamydial conjunctivitis was diagnosed by direct immunofluorescent monoclonal antibody staining of conjunctival smears in 46 of 100 consecutive neonates with conjunctivitis. The remaining 54 infants had bacterial conjunctivitis most commonly caused by Staphylococcus, Streptococcus, and Haemophilus species. A comparison of the direct test with chlamydial cultures demonstrated a sensitivity of 100% and a specificity of 94%, whereas Giemsa stain had a sensitivity of 42% and a specificity of 98%. Nineteen percent of infants treated with oral erythromycin for chlamydial infections in accordance with Centers for Disease Control guidelines had clinical and laboratory evidence of persistent chlamydial conjunctivitis. We conclude that Chlamydia trachomatis is a major cause of neonatal conjunctivitis that can be effectively and rapidly diagnosed by direct immunofluorescent monoclonal antibody staining of conjunctival smears. Further evaluation of treatment regimens appears to be warranted.

Antibodies, Bacterial↗
PubMed2002

Sticky eye, tricky diagnosis.

BACKGROUND: Infective conjunctivitis is common and mostly responds well to supportive management and/or empiric antibiotic treatment. At times the differential diagnosis includes more serious conditions that potentially threaten vision. Recurrence and treatment failures are relatively common. OBJECTIVE: To outline the usual clinical appearance of conjunctivitis and its management. To explore the clinical appearance (with the help of case studies) of conditions that have been mistaken for conjunctivitis, and to consider some of the conditions that may coexist that contribute to recurrence and nonresponsiveness. DISCUSSION: Empiric treatment for presumed bacterial conjunctivitis remains an appropriate course of action. Care must be taken in certain groups who are at high risk of complications. Careful review of the clinical appearance and consideration of other possible diagnoses is mandatory in nonresponding patients.

Adult↗
PubMed1989

[A multicenter randomized study of fusidic acid ophthalmic gel and rifamycine eyedrops in acute conjunctivitis].

A total of 163 patients with acute, presumably bacterial, conjunctivitis were included in a randomized trial, comparing: 1% fusidic acid viscous eye drops, a new ophthalmic formulation of fusidic acid instilled twice daily with rifamycin eye drops, four times daily. Both drugs were given 7 days long. Bacterial origin of the conjunctivitis, mainly staphylococcal, was proved in 75% of the cases. Overall, at the end of the treatment, a satisfactory response, on bacteriological and clinical grounds, was recorded for 87.3 and 89.5% of the patients in the Fucidin gel and rifamycin groups respectively. 9 and 12% of the patients in each group respectively, had a clinical recurrence 15 days after the treatment. No significant difference between the groups clinically and bacteriologically was noted. Side effects, mainly burning and smarting were noted by the investigators in 8 and 11 patients treated by fusilic acid and rifamycin respectively. Two patients were taken out of the study in the rifamycin group because of allergy. The difference between the groups is not significant. The use of fusidic acid viscous eye drops as compared to rifamycin eye drops was judged significantly easier by the patients (P less than 0.02), especially because of the reduced number of applications, the lack of color, and the lase of application.

Acute Disease↗