[Endangering the professional work through eye diseases--endangering the eye through dental work].
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The occurrence of infectious eye diseases in a hospital eye department on the island of Djerba in South Tunisia was analysed by mathematical-statistical methods. The seasonal influence was confirmed in accordance with the local traditional opinion and with previous research papers.
The incidence and prevalence of eye and vision system disorders indicate that the present growth rate of the number of ophthalmologists continues. The number of residency positions in ophthalmology in the United States should remain at about the present number. To assure that those persons having eye disease but not seeking appropriate care are given the opportunity for such care, appropriate guidelines for referral to and from other specialties and health care providers should be established. Suggestions for specific guidelines of referral optometry and ophthalmology are presented. Specific action should be taken by ophthalmology to encourage appropriate groups to implement mass screening methods and public education for eye disease.
Several viral, fungal, and protozoal diseases of the eye are significantly associated with immunologic deficiencies. Of the viral agents, cytomegaly and herpes simplex and zoster cause a discrete necrotizing retinopathy that has the characteristics of vascular occlusion. Measles may result in a delayed retinopathy that is predominantly macular and associated with subacute progressive encephalopathy. Of the fungal agents, Candida and Aspergillus are apt to involve the eye, beginning as choroidal lesions with extension forward to involve the pigment epithelium and retina secondarily. Mucor and Cryptococcus are less common. Toxoplasmosis is the one ocular protozoal disease whose incidence is increased by immunosuppression, and, like the viral diseases, is characterized by a discrete necrotizing retinopathy and probably results from activation of dormant organisms in the retina. Autoimmunity undoubtedly plays an important role in eye disease but its ocular pathogenesis is obscure.
In a three-month survey of some hospital consultant ophthalmic services, 82 instances of complications of contact-lens wearing were reported. Some of the complications gave rise to discomfort, but in only 5 cases was vision impaired.
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A man and his three daughters had massive corneal opacities called in their home village "fish-eye disease" because of the resemblance of the eyes to those of boiled fish. The two living daughters had the same dyslipoproteinaemia, characterised by normal serum cholesterol but raised serum triglycerides, raised very-low-density lipoproteins, strikingly high levels of low-density lipoprotein (LDL) triglycerides. LDL contained normal sized as well as abnormally large particles and a 90% reduction in the level of high-density lipoprotein (HDL) cholesterol. Lecithin:cholesterol acyltransferase (LCAT) activity and the percentage of plasma cholesterol esters were normal, with excluded LCAT-deficiency. Normal electrophoretic mobility of HDL as well as other lipoprotein findings excluded Tangier disease. The clinical and laboratory abnormalities in fish-eye disease are atherosclerosis at old age, visual impairment, and dense corneal opacification. Fish-eye disease thus differs both clinically and in its lipoprotein abnormalities from LCAT-deficiency and Tangier disease.
Since herpes simplex virus (HSV) can cause persistent infection of autonomic ganglia of both humans and experimentally infected animals, we followed the pattern of eye disease and viral growth after HSV inoculation of one superior cervical ganglion in rabbits. Of 27 inoculated animals, eye disease or detectable virus developed in 18. Anterior uveitis was the most common clinical manifestation (94%), but conjunctivitis and dendritic keratitis were also frequent (60%). All 12 uveal-retinal specimens tested and five of seven ipsilateral superior cervical ganglia had detectable virus. If recurrent herpetic iritis in humans is associated with persistent infection of the superior cervical ganglion, autonomic mediators might trigger episodes of virus shedding. In patients with herpetic iritis, then, the use of epinephrine and other adrenergic agonists or antagonists should be avoided.
This review article discusses the evolution and function of the histocompatibility system, the nature of the HLA antigens and their classification, the phenomenon of linkage disequilibrium, and the mechanisms of HLA and disease susceptibility. The reported associations between HLA antigens and various eye diseases are analysed and their significance is discussed. Problems in designing studies on HLA and disease associations are highlighted and suitable statistical procedures for the analysis of the results are outlined.
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B-scan ultrasound of the posterior segment is reported in 154 patients with severe diabetic eye disease. Epiretinal fibrosis, vitreous haemorrhage, vitreous detachment, and retinal detachment were frequently diagnosed. The ultrasonic findings are discussed in relation to the pathological changes in the vitreous in proliferative diabetic retinopathy.
An analysis of 108 cases of vernal eye disease observed in Northern Nigeria. Although the bulbar and tarsal forms usually coexisted, the disease was predominantly bulbar in young children and predominantly palpebral in older patients. Chacteristic pigmentary conjunctival changes were particularly marked in young children. Corneal involvement occurred mostly in those patients with the palpebral form of the disease. The risk of permanent visual impairment in untreated cases appears to be slight.
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