Metabolic, pediatric, and systemic ophthalmology最新文献

Ocular rosacea was diagnosed in 6.3% of a cornea/external disease referral practice where more than half of the patients referred are for corneal surgery. The most common signs and symptoms are also common to many patients in the general practice of ophthalmology, i.e., foreign body sensation, burning, superficial punctate erosions, chalazia and blepharitis. Less common but dangerous to the vision was corneal thinning, vascularization and infiltrates. Three new associated symptoms were described. These were map dot subepithelial opacities, recurrent erosions and moderately severe foreign body sensation, pain or burning with minimal associated signs. Oral tetracycline 250 mg q.i.d. resulted in improvement in almost all patients from 4 to 17 days after initiation of therapy. Although most of the patients have been able to taper and stop therapy, those with foreign body sensation, burning and pain have had recurrences of their symptoms with all attempts at stopping therapy.

Three children with flexion spasms and an ophthalmologic picture characterised by choroidal lacunae are described. Aicardi's syndrome was diagnosed in two cases. A diagnosis of Aicardi's syndrome should include CT scan and/or pneumoencephalographic findings of partial or total agenesis of the corpus callosum and/or other anomalies of the interhemispheric structures. Choroidal lacunae are not entirely pathognomonic.

Three groups of 30 patients each were studied for frequency and severity of anterior chamber bleeding up to 5 days postcataract extraction. One group consisted of diabetic patients receiving Premarin treatment, one group of diabetics without Premarin treatment, and the third of nondiabetic patients. There seems to be less bleeding frequency and especially less bleeding severity in Premarin-treated diabetic patients.

The nature of inflammation in general and the special aspects of ocular inflammation are discussed. Causes of inflammation, the cellular and tissue response to noxious stimuli and the biochemical mediation of the inflammatory response are described. Prostaglandins and their relatives the thromboxanes and prostacyclins are shown to play an important role in the mediation of ocular inflammation. Inhibitors of the biochemical synthesis of prostaglandins show strong potential for use in topical ocular antiinflammatory therapy, however their preclinical evaluation requires the choice of a suitable animal model. A review of animals of both specific and general ocular inflammation is presented.

A clinical and ultramicroscopic review, including discussion of both scanning and transmission microscopy of the lens in the exfoliation syndrome, suggests that the term pseudoexfoliation be retained. Involvement of the lens epithelium, and particularly, the pigment epithelium of the iris and the ciliary body epithelium are emphasized as being the likely sources of the exfoliative fibrils. A case of pseudoexfoliation syndrome in an eye with an eccentric pupil revealed that the granular material seen on the lens capsule occurs only where the iris is in contact with the lens surface and the process may even involve the central anterior capsule under proper conditions. This finding, together with the evidence of continuing deposits after intracapsular cataract extraction, suggests that the granular material is deposited from the iris and that the material formed by the lens epithelium remains within the lens capsule.