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PubMed2001

Detection of equine herpesvirus type 2 (EHV-2) in horses with keratoconjunctivitis.

The prevalence of EHV-2 in 27 horses with keratoconjunctivitis and 21 clinically healthy horses of different ages and stocks were analyzed. We demonstrated that EHV-2 was present in 12 keratoconjunctivitis cases as shown by nested PCR on ocular swabs. This is statistically more often than in the control group, where only two ocular swabs were EHV-2 positive. Cocultivation was successful on peripheral blood leukocytes of healthy and diseased horses but not on swabs. We isolated ten EHV-2 strains from diseased and nine from control horses, whereas 16 isolates showed different restriction enzyme patterns. The results of immunfluorescence and neutralization tests are predictory only in combination with the nested PCR data on ocular swabs. A successful antiviral treatment in nine out of 16 cases supports the aetiological role of EHV-2 in this ocular disease.

Animals↗

PubMed1998

Epidemic keratoconjunctivitis outbreak at a tertiary referral eye care clinic.

An outbreak of epidemic keratoconjunctivitis (EKC) occurred at a tertiary referral eye care clinic between late September and mid-November 1995. Before the outbreak, instruments were cleaned with 70% isopropyl alcohol and handwashing between patients was not routine. Infection control measures were implemented when the outbreak was recognized in mid-October. Control measures included triaging suspected cases to a separate waiting area, cohorting cases to a specific examining room, endorsing the use of gloves and handwashing during examinations of patients, and cleaning instruments with a buffered bleach solution. Thirty-six cases were diagnosed before the infection control measures were taken, and 3 cases were seen after the control measures were taken. Also, numerous secondary cases occurred in the community. No additional cases were diagnosed from DEcember to February 25, 1996. Acquisition of the infection was linked to visits to 4 of 20 physicians in the eye clinic with 61% of cases associated with visits to 1 of those 4 physicians. The use of diagnostic lenses applied directly to the eye was associated with infection (odds ratio = 2.83, 95% confidence interval = 0.79 to 10.4), although this did not reach statistical significance. The use of tonometers, ophthalmic solutions, or laser therapy was not associated with infection, and all environmental cultures were negative. This outbreak emphasizes the need for implementation of routine infection control guidelines to prevent nosocomial transmission of epidemic keratoconjunctivitis and stresses the need for appropriate disinfection of instruments.

Adenoviridae Infections↗

PubMed2003

Oral pilocarpine for the treatment of keratoconjunctivitis sicca with central corneal irregularity.

A 31-year-old female physician with bilateral myopia had unilateral myopic laser in situ keratomileusis in the right eye. The patient was overcorrected with the initial treatment and had 2 subsequent hyperopic treatments, resulting in central corneal irregularity. During the course of treatment, the patient was diagnosed with Sjögren's syndrome with marked keratoconjunctivitis sicca. The patient had anisometropia, aniseikonia, and monocular diplopia and was unable to tolerate contact lenses. Oral pilocarpine (Salagen) was prescribed, which improved salivation, lacrimation, and keratoconjunctivitis sicca. The patient was able to tolerate rigid gas-permeable contact lenses to achieve 20/20 visual acuity in both eyes and regain binocular vision.

Administration, Oral↗

PubMed1988

An epidemic of keratoconjunctivitis due to adenovirus type 37.

An epidemic of keratoconjunctivitis due to adenovirus type 37 in Liverpool in 1984 is reported. Initially serum neutralisation suggested that isolates were type 10 but further neutralisation studies supported by DNA restriction enzyme analysis showed that they were type 37. Clinical and epidemiological features of this cause of epidemic keratoconjunctivitis, recently recognised in the United Kingdom, are presented and the implications for the laboratory investigation discussed.

Adenoviridae Infections↗

PubMed1989

Superior limbic keratoconjunctivitis (SLK).

Superior limbic keratoconjunctivitis (SLK) is a disease characterised by inflammation of the upper palpebral and superior bulbar conjunctiva, keratinisation of the superior limbus and corneal and conjunctival filaments. It may be associated with other diseases such as keratoconjunctivitis sicca, hyperthyroidism and hyperparathyroidism. Although its exact aetiology is unknown, a mechanical hypothesis seems most attractive. Treatment is aimed at altering the abnormal mechanical interaction of the upper lid and superior corneal limbus.

Adult↗

PubMed1998

Blister beetle periorbital dermatitis and keratoconjunctivitis in Tanzania.

Two cases of periorbital dermatitis and one case of keratoconjunctivitis following contact with blister beetle are presented. In Tanzania and Kenya the commonest blister beetle is known as Nairobi Fly and is of the genus Paederus. Ocular symptoms are common, usually secondary to transfer by the fingers of the toxic chemical involved from elsewhere on the skin. Blister beetle keratoconjunctivitis has not previously been described in detail.

Adult↗

PubMed2000

Epidemiology of infectious keratoconjunctivitis in cattle in south-east Ethiopia.

The aim of the study was to determine the prevalence of infectious keratoconjunctivitis on cross-breed dairy farms and to evaluate factors that influence its distribution. A total of 11 dairy farms and one cattle cross-breeding farm in different parts of Arsi region, south-east Ethiopia were clinically and bacteriologically investigated from February 1989 to December 1990. Out of 5221 local zebu and cross-breed dairy animals, 110 were found to have different degrees of infectious bovine keratoconjunctivitis. Of these, 94 (85.5%) were unilateral and 16 (14.5%) were bilateral. The prevalence of the disease was significantly (P < 0.001) influenced by age and breed; high exotic blood level and younger age groups were mainly affected. However, severity of the disease was not significantly associated with age (P > 0.750). Moraxella bovis was isolated from 88 (80%) of the 110 bacteriologically positive cases. Of these isolates, 61 (69%) were haemolytic and 27 (31%) were non-haemolytic strains. Infection with M. bovis was unilateral. Concurrent infections with M. bovis included Actinomyces pyogenes 23 (21%), Staphylococcus aureus 17 (15%), Pasteurella haemolytica nine (8%), Escherichia coli eight (7%) and Proteus spp. four (3.6%).

Animals↗

PubMed1988

Ovine keratoconjunctivitis experimentally induced by instillation of Mycoplasma conjunctivae.

Five sheep, free from Mycoplasma conjunctivae and ocular Chlamydia infection, were experimentally inoculated with M. conjunctivae and five more sheep were exposed to the infection by contact. Keratoconjunctivitis developed in all ten sheep. As in natural outbreaks of infectious keratoconjunctivitis (IKC), clinical signs were generally moderate and transient, and recurred in some sheep. M. conjunctivae was detected throughout the 53-day observation period. Clinical diagnosis was confirmed by histopathologic examination of three sheep. Moraxella ovis, found in six of the ten sheep before the start of the experiment, appeared to play no etiologic role in the development of IKC.

Animals↗

PubMed2006

An outbreak of epidemic keratoconjunctivitis caused by a new intermediate adenovirus 22/H8 identified by molecular typing.

In a 4-week period, 12 patients contracted adenoviral keratoconjunctivitis. Eight of these patients had visited the same ophthalmologist's practice before onset of symptoms. Adenovirus was detected in swab specimens obtained from 9 patients. Sequence-based typing of 2 isolates revealed type 22/H8. This is, to our knowledge, the first report of a keratoconjunctivitis outbreak caused by an intermediate adenovirus type 22/H8.

Adenoviridae↗

PubMed2005

Tolerability and efficacy of N-chlorotaurine in epidemic keratoconjunctivitis--a double-blind, randomized, phase-2 clinical trial.

The aim of this study was to assess the tolerability and efficacy of N-chlorotaurine (NCT), an endogenous antimicrobial agent, in epidemic keratoconjunctivitis. In a prospective double-blind, randomized phase 2b study, the infected eyes were treated for 7 days with eye drops containing 1% aqueous solution of N-chlorotaurine (33 subjects) or gentamicin (27 subjects, control group). Adenovirus types 3, 4, 8, 19, and 37 were detected in 39 subjects (65%), enteroviruses in 8 (13.3%), and staphylococci in 5 (8.3%). Subjective and objective symptoms were scaled and added to a subjective and objective score, respectively, on day 1 (baseline), day 4, and day 8. Analyzing the whole study population, the subjective score on day 8 was lower in the NCT group (P = 0.016), whereas there were no differences in the objective score. However, in severe infections caused by adenovirus type 8 (n = 20) both the subjective and objective score were lower in the NCT group on day 4 (P = 0.003 and 0.015, respectively), which was also true for the subjective score on day 8 (P = 0.004) in this subgroup. The frequency of subepithelial infiltrates was similar in both groups. N-chlorotaurine was well-tolerated, shortened the duration of illness, and seems to be a useful causative therapeutic approach in severe epidemic keratoconjunctivitis.

Adenoviridae↗

PubMed1991

A community outbreak of epidemic keratoconjunctivitis in central Australia due to adenovirus type 8.

A large outbreak of epidemic keratoconjunctivitis occurred in Alice Springs, Australia, between July and September 1989. Initially, there was a large outbreak within two child care centers, followed by a more prolonged outbreak within the community. A simultaneous outbreak occurred among staff at the local hospital. Infected children developed mild conjunctivitis, whereas adults developed typical keratoconjunctivitis. Conjunctival swabs from 30 cases were cultured and adenovirus was recovered from 18, all of which were typed by neutralization assay as adenovirus type 8. DNA restriction fragment analysis of the genomes of 5 isolates revealed they were identical, distinct from prototype adenovirus type 8, and nearly identical to adenovirus genome type 8C (Ad-8C), which was previously reported in the southern United States in the early 1970s. Ad-8C was present in another region of Australia greater than or equal to 1 year before the epidemic.

Adenovirus Infections, Human↗

PubMed1979

Five-year analysis of adenovirus 8 antibody levels in an industrial community following an outbreak of keratoconjunctivitis.

Serum hemagglutination-inhibition (HI) antibody titers were monitored for five years with samples from 79 keratoconjunctivitis patients with type 8 adenovirus (AV-8) infection. Geometric mean antibody titers declined from 1:161 at the peak of the epidemic to 1:56 after five years. Computerized analysis of the decline in geometric mean antibody titer indicates that most patients will have a serum HI titer of 1:25 by 10 years after their clinical infection. These residual antibody levels and the consistent failure to document re-infection with AV-8 suggest that recurrent episodes of keratoconjunctivitis are caused by adenovirus serotypes other than type 8.

Adenoviruses, Human↗

PubMed1992

Unpreserved carboxymethylcellulose artificial tears evaluated in patients with keratoconjunctivitis sicca.

In order to evaluate the therapeutic value of an unpreserved carboxymethylcellulose-based artificial tear in treatment of keratoconjunctivitis sicca (KCS), 56 patients with severe keratoconjunctivitis sicca were enrolled, at a single study center, in a randomized, double-masked, 8-week comparison with a preserved hydroxypropylmethylcellulose (HMC)-based artificial tear. Patients treated with the carboxymethylcellulose (CMC)-based tear showed significant improvement in fluorescein staining, symptoms, and impression cytology grades. Patients treated with HMC-based tears showed minimal improvement in a few variables. Impression cytology specimens were analyzed by a modified technique that maps the distribution of the various grades present on the specimen. With this technique, improvement in the cytology grades was noted in the group of patients using CMC-based tears. The improvement correlated with observed decreases in symptoms of discomfort and with scores for superficial punctate staining. This study supports the observed therapeutic value of unpreserved CMC-based artificial tears and suggests the possible reversal of squamous metaplasia in patients with KCS. Further studies are required to separate the benefit of the CMC formulation from the benefits of preservative elimination.

Carboxymethylcellulose Sodium↗

PubMed1993

Pilot trial of cyclosporine 1% ophthalmic ointment in the treatment of keratoconjunctivitis sicca.

This trial was a randomized, double-masked, crossover study during which patients with keratoconjunctivitis sicca underwent 6 weeks of treatment with either cyclosporine 1% ophthalmic ointment or placebo followed by 6 weeks of the alternative treatment. Washout periods using only unpreserved artificial tears preceded both treatment cycles. Twenty-five patients completed the first treatment period, but only eight met entry criteria for period II. Cyclosporine ointment was associated with initial mild to moderate redness, itching, and burning that returned to baseline levels within 1-2 weeks. Rose Bengal results and results of four subjective (patient diary) efficacy parameters favored cyclosporine: foreign body sensation, overall symptoms, hours of symptom control per day, and overall effectiveness. No systemic adverse events or laboratory abnormalities occurred. We conclude that (a) the crossover design is inappropriate for studying this disease; (b) mild to moderate itching, redness, and burning occur initially with cyclosporine administration, although tolerance quickly develops; (c) cyclosporine appears to benefit the ocular surface in keratoconjunctivitis sicca; and (d) further trials in this syndrome are warranted.

Adult↗

PubMed2006

Alterations of the ocular surface epithelial mucins 1, 2, 4 and the tear functions in patients with atopic keratoconjunctivitis.

BACKGROUND: An increased understanding of the ocular surface alterations at the cellular level in the conjunctiva and the cornea, may help explain the pathogenesis and the subsequent clinical appearance of atopic ocular allergies, which may be potentially blinding. PURPOSE: To investigate MUC 1, 2 and 4 alterations, tear function and the ocular surface disorder in patients with atopic keratoconjunctivitis. METHODS: Twenty-eight eyes of 14 atopic keratoconjunctivitis patients as well as 22 eyes of 11 age-and sex-matched normal subjects were studied. The subjects underwent corneal sensitivity measurements, Schirmer's test, tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface, conjunctival impression cytology and brush cytology. Impression cytology samples underwent periodic acid-Schiff and immunohistochemical staining with MUC 1, 2 and 4 antibodies. Brush cytology specimens underwent evaluation for inflammatory cell numbers and quantitative real-time-PCR for MUC 1, 2 and 4 mRNA expression. Patient eyes with fluorescein and Rose Bengal scores greater than four points were regarded to have significant epithelial disease in this study. RESULTS: The mean corneal sensitivity and BUT values were significantly lower in atopic patients with significant epithelial disease, compared with patients with insignificant epithelial disease and controls (P < 0.01). Brush cytology specimens from patients with significant epithelial disease revealed significantly higher numbers of inflammatory cells (P < 0.01). Specimens from patient eyes showed positive staining for MUC 1, 2 and 4. MUC 1, 2 and 4 mRNA expressions were significantly higher in eyes with significant epithelial disease compared with eyes with insignificant epithelial disease and eyes of control subjects. CONCLUSION: Ocular surface inflammation, decline in corneal sensitivity, tear film instability, changes in conjunctival epithelial MUC 1, 2 and 4 mRNA expressions were thought to be important in the pathogenesis of atopic ocular surface disease.

Adolescent↗

PubMed2006

Sjögren's syndrome-like disease of C57BL/6.NOD-Aec1 Aec2 mice: gender differences in keratoconjunctivitis sicca defined by a cross-over in the chromosome 3 Aec1 locus.

Sjögren's syndrome (SjS) is a systemic autoimmune disease in which an immunological attack primarily against the salivary and lacrimal glands results in loss of acinar cell tissue and function leading to stomatitis sicca and keratoconjunctivitis sicca. In recent years, the NOD mouse has become an accepted model of SjS, exhibiting a spontaneously developing disease that strongly mimics the human condition. Two genetic regions, one on chromosome 1 (designated Aec2) and the second on chromosome 3 (designated Aec1) of NOD mice, have been shown to be necessary and sufficient to recapitulate SjS-like disease in non-susceptible C57BL/6 mice. Here we describe a newly derived strain, C57BL/6.NOD-Aec1R1Aec2, in which a recombination in Aec1 has resulted in reducing this genetic region to less than 20 cM from 48.5 cM. Profiling of this recombinant inbred strain has revealed that male mice maintain a full SjS-like disease, whereas female mice exhibit stomatitis sicca in the absence of detectable keratoconjunctivitis sicca. These data suggest SjS-like disease in the NOD mouse shows gender-specific regulation determined by autosomal genes.

Animals↗

PubMed1996

Isolation of Mycoplasma conjunctivae from conjunctival swabs of Alpine ibex (Capra ibex ibex) affected with infectious keratoconjunctivitis.

Mycoplasma conjunctivae was isolated four times from the eyes of nine Alpine ibex (Capra ibex ibex) suffering from keratoconjunctivitis. The animals examined were affected in two different outbreaks in the Swiss Alps. Parasitological and bacteriological studies, including investigations for chlamydia and mycoplasmas, were performed. The results indicate that M. conjunctivae is the primary pathogenic agent causing infectious keratoconjunctivitis in this species.

Animals↗

PubMed1986

Evaluation of sodium cromoglycate and medrysone in the management of atopic keratoconjunctivitis: a double masked clinical study.

The efficacy of topical sodium cromoglycate and medrysone was evaluated in 38 patients suffering from atopic keratoconjunctivitis. It was found that medrysone (1%) significantly improved the symptoms of itching, watering, photophobia and hyperaemia, while sodium cromoglycate (2%) was found to be ineffective. Tear prostaglandin E2 and histamine levels did not decrease significantly after sodium cromoglycate therapy. The findings of the present study reveal that sodium cromoglycate has no significant role in the management of atopic keratoconjunctivitis.

Adolescent↗