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Rheumatic Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Keratoconjunctivitis sicca causes various ocular symptoms, including the sensation of a foreign body, burning, tiredness, dryness, redness, blurred vision, itchiness, soreness, pain, photosensitivity and excessive secretion.
Geriatric hair and scalp disorders
Published in Robert A. Norman, Geriatric Dermatology, 2020
The onset is often preceded by a prodrome consisting of pain, itching and paresthesias. Prodromal pain, pain during acute phase infection and post-herpetic neuralgia are more commonly experienced by patients over 50 years old. Comorbidity symptoms such as insomnia are common in the elderly134. Postherpetic neuralgia is a serious consequence of herpes zoster and occurs more commonly and lasts longer in patients over 60 years old133,135. It is often severe and refractory to treatment. More than 50% of patients with herpes zoster over 60 years of age will develop post-herpetic neuralgia which may persist for months or even years133. It is more common in those with trigeminal involvement. Higa and colleagues found that the extent of the involvement of the skin correlates with the duration of post-herpetic pain in all age groups135. However, patients over 60 years old had more extensive lesions. Involvement of the cornea is considered a medical emergency causing keratoconjunctivitis, uveitis and ocular motor paralysis136. Hair loss and eventual scarring may occur in areas of ulceration.
Adenovirus
Published in Avindra Nath, Joseph R. Berger, Clinical Neurovirology, 2020
Jennifer McGuire, Joseph R. Berger
Antigen assays are particularly useful for the detection of the fastidious adenovirus types 40 and 41 in stool samples. Another potential application is in the rapid diagnosis of epidemic diseases such as keratoconjunctivitis (EKC). Direct adenovirus antigen assays can also be used to screen cell cultures before the development of CPE as well as to confirm the presence of adenovirus in cell cultures positive for CPE.
Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2023
Paras P. Shah, Yoav Glidai, Richard Braunstein, Matthew Gorski, Jung Lee, Farihah Anwar, Amelia Schrier, Jules Winokur, Anne S. Steiner
In our practice, several, but not all, subjects had a history of corneal inflammatory diseases (n = 6, Table 1). Three patients had a history of HSV keratitis, while a fourth previously had zoster keratitis. Additionally, two patients had a history of keratoconjunctivitis, collectively representing the cohort of six patients who had reactivation of keratitis. Three patients did not have any history of corneal inflammatory diseases. In addition, our cohort of patients who experienced keratitis in temporal proximity to COVID-19 vaccination was relatively evenly distributed between both LNP-formulated COVID-19 vaccines available in the United States, BNT162b2 and mRNA-1273 (55.6% and 44.4%, respectively). Within our practice, there were no observed cases among recipients of the Ad.26.COV2.S (Johnson & Johnson) vaccine, which instead uses an adenovirus serotype 26 vector encoding the SARS-CoV-2 spike protein.41 CDC data shows that out of over 200 million fully vaccinated Americans, only 8% received the Johnson & Johnson vaccine, while the rest received the Pfizer-BioNTech or Moderna mRNA vaccines.
Non-genetic risk factors for keratoconus
Published in Clinical and Experimental Optometry, 2023
Minji Song, Qing Yi Fang, Ishith Seth, Paul N Baird, Mark D Daniell, Srujana Sahebjada
Naderan et al.2,23 evaluated the effect of allergic diseases on keratoconus and reported an increased prevalence of vernal keratoconjunctivitis and allergic conjunctivitis in keratoconic patients. They also found that patients with allergic conjunctival diseases had more severe keratoconus in comparison with keratoconus patients without allergic diseases.23 Lee et al.22 reported 37% increased odds of developing keratoconus (OR 1.37; 95% CI = 1.12–1.67) in subjects with allergic conjunctivitis. Wang et al.25 found alterations in the corneal tomography, biomechanics and epithelial thickness in allergic conjunctivitis patients which are consistent with the corneal changes seen in patients with early keratoconus. This demonstrates the possibility of allergic conjunctivitis as a risk factor for the progression to keratoconus. Weng et al.26 also concluded that there is an increased risk of developing keratoconus in atopic keratoconjunctivitis patients. Therefore, patients who experience allergic conjunctival disease should be closely monitored and advised to routinely undergo corneal tomographic and biomechanical measurements for early keratoconus screening.
A Review of Ocular Graft-versus-Host Disease: Pathophysiology, Clinical Presentation and Management
Published in Ocular Immunology and Inflammation, 2021
Jimena Tatiana Carreno-Galeano, Thomas H. Dohlman, Stella Kim, Jia Yin, Reza Dana
Ocular GVHD (oGVHD) arises in 30 to 60% of patients who undergo HSCT and in 60 to 90% of patients with systemic GVHD.6,7 oGVHD is characterized by involvement of the lacrimal glands, eyelids and ocular surface, with resulting inflammation and fibrosis in these tissues. These changes produce symptoms of dry, painful eyes and signs of keratoconjunctivitis sicca (dry eye) and sometimes even cicatricial conjunctivitis. These changes have the potential to lead to severe visual impairment and a significant reduction in patient quality of life.8 The management of oGVHD can be challenging due to the persistence and severity of patient systems, and a multidisciplinary approach is critical to improving patient outcomes. Here, we present a comprehensive review of oGVHD, including disease pathophysiology, clinical presentation and current management strategies.