Showing papers on "corneal ulcer published in 1987"

Corneal ulceration, measles, and childhood blindness in Tanzania.

Abstract: One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. Herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin A deficiency was the major cause of bilateral ulceration, subsequent blindness, and mortality in this series. Other significant causes of childhood corneal ulceration were the use of traditional eye medicines, confluent measles keratitis, and ophthalmia neonatorum. We discuss the various mechanisms by which measles causes corneal ulceration, and the priorities in prevention and management of corneal ulceration in African children.

Extended-wear lenses, biofilm, and bacterial adhesion.

Abstract: • While medical scientific knowledge pertaining to bacterial adhesion to biomaterials has become a rapidly growing field in most areas of medicine, its significance in ophthalmic infections has not been emphasized. Corneal bacterial ulceration in patients wearing extended-wear contact lenses has become a problem of epidemic proportions. The designation of the contact lens itself as a suitable substratum for bacterial colonization and as a source of subsequent inoculum to compromised epithelial cells are important factors in the pathophysiology of corneal ulcer formation. We demonstrate polysaccharide-(biofilm-)mediated adhesion to two ophthalmic pathogens ( Pseudomonas aeruginosa and Staphylococcus epidermidis ) to the surface of a typical extended-wear contact lens in vitro using cytochemistry and scanning and transmission electron microscopic techniques. This interaction between the biomaterial and bacterial organisms, which represents a favorable self-protective environment for propagation and inoculation, is a previously overlooked area of importance in the mechanism of corneal ulceration associated with hydrophilic (soft) contact lenses.

Host, microbial, and pharmacological factors affecting the outcome of suppurative keratitis.

Abstract: A review of 87 cases of microbial keratitis in South Australia was made to determine the factors which influence the outcome of the disease. The preceding pathology and the extent of ulceration at presentation were found to be significant, while the presence of hypopyon was less important. Infection with Pseudomonas aeruginosa was most likely to result in a poor outcome. Most patients had a history of traumatic injury, herpes simplex keratitis, or a corneal graft. The choice of gentamicin and a cephalosporin as appropriate initial therapy in Australia was supported. The results are discussed with reference to current research objectives.

Mycobacterium chelonei infection of a corneal graft.

Abstract: We present a case of Mycobacterium chelonei infection in a corneal graft. The chronic ulceration and stromal infiltration followed a well defined course and eventually responded to topical amikacin, though a further graft was required. Previous cases of keratitis due to the M. fortuitum complex are reviewed.

Cyclosporin therapy in Mooren's ulcer.

Abstract: Mooren's ulcer is a rare disease of presumed autoimmune aetiology. Some cases run a chronic severe course and fail to respond to local and systemic therapy. We report here such a case with bilateral Mooren's ulcer that failed to respond to local therapy with topical corticosteroids, silver nitrate, and conjunctival resection, as well as systemic immunosuppression with corticosteroids, cyclophosphamide, and azathioprine. Systemic cyclosporin (10 mg/kg/day) resulted in resolution of the corneal ulceration within two weeks of beginning treatment, and the patient has remained in remission after 15 months of therapy. Cyclosporin side effects included hirsutism, hypertension, increased blood levels of urea and creatinine, and abnormalities in liver function tests. All these resolved on reducing the dosage of cyclosporin. The results in this case suggest that cyclosporin is an effective agent in patients with severe sight threatening Mooren's ulcer.

Topical fibronectin therapy in persistent corneal ulceration.

Abstract: Fifteen patients with 20 episodes of persistent corneal ulceration, resistant to conventional therapy, were treated with topical autologous fibronectin. Thirteen corneal ulcers (eight patients) developed following penetrating keratoplasty, three patients had mucous membrane pemphigoid, two patients had herpetic keratitis and one each had Sjogren's syndrome and a trophic corneal ulcer. A standard protocol for fibronectin administration was followed. This therapy healed 16 of the 20 ulcers after a mean duration of treatment of 2.3 months. Corneal ulceration associated with mucous membrane pemphigoid failed to respond to fibronectin. Corneal ulcers which recurred after cessation of fibronectin responded to reintroduction of this therapy. Topical fibronectin is an effective therapy for refractory corneal ulceration and is free of major side effects.

Nocardia asteroides as a Cause of Corneal Ulcer

Abstract: To the Editor. —Numerous microorganisms have been found to cause corneal ulceration. Often, conventional "nonpathogenic" organisms can become virulent in the presence of optimal conditions in the host. There are increasing reports of the involvement of saprophytes such as atypical mycobacteria, Acanthamoeba , and so on, in corneal ulcers. However, reports of corneal ulceration due to Nocardia species are infrequent, 1 and species belonging to the order Actinomycetales are often forgotten as possible causative agents. We report four patients with corneal ulcers caused by Nocardia asteroides in whom the diagnosis was made on the basis of microbiologic investigations and in whom prompt institution of specific therapy led to rapid and complete resolution. Report of Cases. —Three men and one woman, 25 to 55 years old, presented with redness, pain, and decreased visual acuity in the affected eye. All patients had been treated earlier with various antibiotics for one to four weeks

Keratomycosis due to Alternaria alternata corneal transplant infection.

Abstract: A 53-year-old woman was found to have an ulcer on her successfully transplanted corneal graft. Many fungal elements were observed in the smear of the ulcerated tissue, andAlternaria alternata was cultured. The ulcer was treated with pimaricin and thimerosol topically, and 5-fluorocytocin (5FC) generally and healed to scar after two months. The ulcer did not invade the host cornea, but remained in the donner cornea in all clinical course. The MIC of five drugs on the isolated strain was following; thimerosal 0.0063, pimaricin 2.0, amphotericin B 3.2, aystatin 6.3 and 5FC 100.0 μg/ml each.

Mycobacterium avium-intracellulare corneal ulcer.

Abstract: A healthy 28-year-old man developed a slowly progressive corneal ulcer 21 months after an episode of corneal trauma. Acid-fast bacilli were identified in corneal scrapings, and the causative organism was identified as Mycobacterium avium-intracellulare. Medical treatment with topical amikacin and oral rifampin was ineffective, and a therapeutic penetrating keratoplasty was necessary to cure the infection. To the best of our knowledge, this is only the second reported case of a corneal infection caused by a slow-growing nontuberculous mycobacterium (Runyon groups I, II, and III) and the first caused by M. avium-intracellulare. Slowly growing nontuberculous mycobacteria should be considered among those organisms that cause corneal infection, especially in cases characterized by a protracted course and lack of response to conventional antimicrobial therapy.

Corneal Ulcer Due to Listeria monocytogenes

Abstract: We present a patient with a corneal ulcer due to Listeria monocytogenes, which has not previously been considered to be a feature of human listeriosis. The ulcer responded to topical and subconjunctival gentamicin and cephaloridine. Subsequent management was complicated by the development of a fibrinous pupillary membrane leading to pupillary block requiring iridotomy and later vitrectomy with trabeculectomy. Listeria monocytogenes may be confused with diphtheroid contaminants seen in corneal ulcer scrapings and is probably underreported as a cause for microbial keratitis.

Factors predisposing to central corneal ulceration in a developing population.

Abstract: Over a 1-year period all patients presenting to St John's Eye Hospital with corneal ulceration were studied. The local and general factors predisposing to central (primarily infective) corneal ulceration are discussed. Episodes of corneal trauma and climatic droplet keratopathy were the major local factors and these occurred against the background of a generally poor nutritional status.

Spontane Hornhautruptur nach Strontiumbestrahlung eines Plattenepithelkarzinoms der Konjunktiva

Abstract: A 87-year-old female patient with a squamous cell carcinoma of the conjunctiva was treated with local strontium-90 irradiation (with a so-called ‘Dermaplatte’). In spite of a relatively low dosage, radiotherapy was followed by a corneal ulcer with consecutive rupture of the cornea. The cause of this unexpected perforation was, besides the effect of low-dose irradiation, probably a metabolic disorder of the cornea and a disturbance of the tear film due to the carcinoma which had spread on Bowman’s layer of the cornea in an exophytic manner and was accompanied by a dense lymphocytic infiltration. An exenteration was performed and, at the last examination (1 year later), no local recurrence could be detected.

Cyclo-cryo therapy in glaucoma of advanced stage.

Abstract: From our clinical trials of different available antifungal drugs for the cases of keratomycosis, we conclude that Econazole 1% ointment is a safe and effective antifungal agent having a wide range of antifungal activity. With rising incidence of mycotic ulcer particularly in rural population where facilities for laboratory diagnosis and drug sensitivity tests for antifungal drugs are lacking Econazole can be useful as a broad spectrum antifungal agent for the cases of keratomycosis and also could be used as a prophylactic in cases of traumatic corneal ulcer as those are particularly at risk.

Application of betadine (povidone iodine) to infected corneal ulcer.

Abstract: A new approach of touching betadine directly to infected corneal ulcers in addition to customary treatment is suggested. A report of 35 cases of infected corneal ulcers and keratitis where it was done is studied.

Animal experiment model of keratomycosis

Abstract: A model of experimental keratomycosis in the rabbit eye is described. Candida albicans strain DSM 70010 (10 microliters; 2.5 X 10(5) cells) is injected intracorneally without employing immunosuppressive measures. This strain is characterized by marked germ-tube formation, which apparently is a major cause of its virulence. All 17 eyes developed an infiltration of the cornea two days after injection. On Day 6 (mean value; standard error +/- 2.34 days) this infiltration developed synchronously to a severe corneal ulcer with hypopyon. The infection remained active for about two weeks and was either complicated by a descemetocele or perforation or led to a reparatory stage with extensive vascularization and successive leukoma. The model presented is reproducible for the first time and is therefore recommended for experimental evaluation of new therapeutic concepts.

Treatment of Sjögren’s Syndrome

Abstract: Patients with Sjogren’s syndrome should be seen regularly by a rheumatologist, an ophthalmologist, and a dentist. They need to be followed closely for significant functional deterioration, superimposed signs of disease complications or significant changes in the course of the disease. For example, regular outpatient visits with serial observations of pertinent laboratory parameters may allow for the early diagnosis of extraglandular complications or malignancy.

[Corneal complications in Goldenhar-Gorlin syndrome].

Abstract: The authors describe 3-year-old Italian girl with oculoauriculovertebral dysplasia (Goldenhar-Gorlin syndrome) accompanied by corneal anesthesia and reduced tear production complicated by progressive neuroparalytic corneal ulcer

Surgical therapy of a Pseudomonas corneal ulcer in a diabetic.

Abstract: A 30-year-old white woman with diabetes was seen with a Pseudomonas corneal ulcer. The ulcer progressed despite appropriate antibiotics, and the patient was treated with surgical debridement. Pseudomonas infections in a compromised host are discussed.

Comparative study of acyclovir and 5 I.D.U. in the management of viral corneal ulcer.

Abstract: Thus, we found that the role of Acyclovir in the treatment of viral corneal ulcer is definitely better and quicker. It takes less time for healing of corneal ulcer and as a result less hospitalisation is needed.