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Immunotherapy of Graves’ Eye Disease
Published in George S. Eisenbarth, Immunotherapy of Diabetes and Selected Autoimmune Diseases, 2019
N. R. Farid, G. Kahaly, J. Beyer
We therefore consider that it is justifiable to “wait and see” only in stages of Graves’ ophthalmopathy without inflammatory reaction. Signs of lid retraction, or stare, decline after elimination of hyperthyroidism. Exophthalmos, chemosis, and diplopia, in our opinion, require timely specific therapy. In order to minimize the extent of the permanent damage as much as possible, we administer anti-inflammatory and immunosuppressant treatment in every progressive Graves’ ophthalmopathy case with an unequivocal clinical diagnosis.
Tick Typhus
Published in James H. S. Gear, CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
When the infection is introduced through the conjunctiva, marked inflammation with dilatation of the capillaries associated with swelling and edema of the tissues of the eyelids takes place (Figure 1). The swelling may be so marked as to cause Chemosis or closure of the eye. Shallow ulcers may form on the conjunctiva.
Cyanides: Toxicology, Clinical Presentation, and Medical Management
Published in Brian J. Lukey, James A. Romano, Salem Harry, Chemical Warfare Agents, 2019
Gary A. Rockwood, Gennady E. Platoff Jr., Harry Salem
Transocular Toxicity. Instillation of HCN and its salts into the inferior conjunctival sac results in the absorption of lethal amounts of CN. HCN is significantly more lethally toxic by this route than either NaCN or KCN. The effect of varying the physical state of local presentation of NaCN to the eye has shown that both solution (10–20%) and solid present a similar hazard (Ballantyne, 1983b). Signs of toxicity appear in the following order: rapid breathing, weak and ataxic movements, convulsions, tonic spasms, irregular and shallow breathing, coma, and cessation of breathing. For HCN, signs develop within 30–60 s, and time to convulsions is from 45 to 90 s. The corresponding times with NaCN and KCN are 2–2.5 min and 2–3 min. Time to death is 3–12 min postinstillation. Thus, following instillation of CN into the conjunctival sac, it is readily absorbed into the systemic circulation. The factors responsible for this are conjunctival hyperemia, drainage through the nasolacrimal duct to the vascular nasal mucosa, and absorption into the systemic circulation with minimal hepatic first-pass detoxification. Local irritant effects on the eye are conjunctival hyperemia and mild chemosis (Ballantyne, 1983b).
COVID-19-related Conjunctivitis Review: Clinical Features and Management
Published in Ocular Immunology and Inflammation, 2023
William Binotti, Pedram Hamrah
Early studies with systemic COVID-19 infection have reported ocular involvement, to which follicular conjunctivitis was the main manifestation in infected patients.5–15,22,23 The characteristics of the conjunctivitis are similar to the other viral forms, namely epiphora, conjunctival hyperemia, conjunctival and eyelid chemosis, tarsal follicular reaction, and preauricular and submandibular lymphadenopathy (Figure 1).21 The most common ocular signs and symptoms were conjunctival chemosis, ocular redness, ocular pain, discharge, and conjunctival follicular reaction.7,10 The literature shows a wide incidence range of conjunctivitis (0.8–31.6%) in these patients.5,6,22,23 The wide range is mainly explained by the heterogeneity of the studies. While some studies relied on questionnaires from infected patients after being discharged from the hospital, other studies reported ocular findings on hospitalized or critically ill COVID-19 patients without slit-lamp examination. In contrast, the eye is often overlooked in these patients that are often under acute life-threatening situations, where ocular manifestations might be under-reported or underestimated.
Studying the ophthalmic toxicity potential of developed ketoconazole loaded nanoemulsion in situ gel formulation for ophthalmic administration
Published in Toxicology Mechanisms and Methods, 2021
Mohammad Tavakoli, Mohammad Mehdi Mahboobian, Fatemeh Nouri, Mojdeh Mohammadi
Irritation potential of control solutions and KZ-NE in situ gel formulation appraised based on the visual observation of the cornea, iris, and conjunctiva tissues of every rabbit for any manifestation of irritation after 1, 2, 3, 4, 6, 8, and 24 h. Based on the descriptions in Table 1, the score of irritation potential is estimated for each test substance (Table 6). SDS administration (1%w/v), as a positive control, immediately after instillation induced severe ophthalmic irritation such as conjunctival discharge, chemosis, and redness (score = 3). Conjunctival discharge disappeared after one hour, but chemosis and redness were still observed (score = 2). After three hours, chemosis and redness slightly decreased and faded over time. Using phosphate buffer (pH = 7.4) as negative control didn’t show any significant symptoms of irritation reactions in the cornea, conjunctiva tissue, and iris (score = 0). After KZ-NE in situ gel formulation instillation in the cul de sac of the conjunctiva, a slight discharge was detected, but the cornea and conjunctival vessels were entirely normal (score = 0.33). Partial discharge vanished over time, and no sign of irritant responses was noticed during the following hours (score = 0). Based on our results it can be concluded that KZ-NE in situ gel formulation was nonirritant and well-tolerated.
Neuro-Ophthalmic Sarcoidosis
Published in Neuro-Ophthalmology, 2020
Giovanni Campagna, Claudia M. Prospero Ponce, Aroucha Vickers, Bennett Yau-Bun Hong, Francesco Pellegrini, Daniele Cirone, Francesco Romano, Piernicola Machin, Andrew G. Lee
A 50-year-old Caucasian woman developed left upper eyelid ptosis of one-month duration with increasing retrobulbar fullness, worsening proptosis and tearing OS. Her past ocular history included left high myopia and left presumed strabismic amblyopia OS (best corrected visual acuity 20/200 OS). She was otherwise healthy and took no medications. Extraocular motility exam of the left eye revealed normal adduction but all other ductions were impaired OS. The right eye moved normally. There was a 3 mm ptosis of the left upper eyelid (Figure 2a) and 3 mm of newly acquired left proptosis. There was a left RAPD and generalised left visual field depression. Slit lamp examination disclosed mild conjunctival chemosis OS. The fundus examination revealed chorioretinal striae nasal to the optic disc in the setting of a myopic fundus. The right eye was entirely normal on examination. MRI of the brain and orbits with contrast revealed marked thickening of extraocular muscles (EOM) and tendons with a lesser involvement of the lateral rectus muscle on the left side (Figure 2b). The lateral wall of the cavernous sinus was involved. Medial rectus muscle biopsy showed histologic findings of non-caseating granuloma consistent with orbital sarcoidosis (Figure 2c–d).