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The salivary glands
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
In the instance of facial nerve palsy, diligent eye care to avoid exposure keratitis is necessary. Artificial tears, lubricating ointment and protective dressings should be used.
Familial Dysautonomia
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
The corneal hypesthesia and alacrima predispose the cornea to neurotropic corneal ulcerations due to undetected trauma and excessive dryness. Corneal complications have been decreasing with regular use of artificial tear solutions containing methylcellulose and maintenance of normal body hydration. Artificial tears are instilled three to six times daily, depending on the child’s own baseline eye moisture, environmental conditions and whether or not the child is febrile or dehydrated. Moisture chamber spectacle attachments help to maintain eye moisture and protect the eye from wind and foreign bodies. Tarsorraphy has been reserved for unresponsive and chronic situations. Soft contact lenses are also beneficial in promoting corneal healing. Corneal transplants have had limited success.
The diagnostic evaluation and management of hyperthyroidism due to Graves’ disease, toxic nodules, and toxic multinodular goiter
Published in David S. Cooper, Jennifer A. Sipos, Medical Management of Thyroid Disease, 2018
Since the cause of Graves’ ophthalmopathy is unknown, treatment is directed at treating symptoms. In most patients, the problem is self-limited, often resolving as the hyperthyroidism is treated. Although most experts feel that it is best for the patient to be euthyroid, there is no consistent relationship between a patient’s thyroid function and progression or regression of eye disease. There is good evidence that smoking exacerbates Graves’ ophthalmopathy (172), and it is suggested that smoking cessation has a beneficial effect (173). The mechanism by which smoking affects Graves’ ophthalmopathy is unknown. There is solid evidence that radioactive iodine therapy can exacerbate Graves’ eye disease when it is moderately severe at baseline (130, 131), likely due to the increase in TRAb levels after treatment (39). When the condition is mild, symptoms such as irritation, tearing, and photophobia are easily treated with artificial tears and lubricating eye ointments. In more severe cases, high doses of glucocorticoids usually will result in prompt improvement in local symptoms and ocular motility. Data from randomized clinical trials have shown that intravenous pulse therapy with methylprednisolone is more effective and safer than high-dose oral therapy (174, 175). One commonly used regimen is methylprednisolone 500 mg IV weekly for 6 weeks followed by 250 mg IV for 6 weeks, which resulted in a 77% response rate and minimal toxicity (176). Unfortunately, as the glucocorticoid is tapered, the ophthalmopathy often flares up, so that other measures are sometimes needed.
Comparison of matrix metallopeptidase-9 expression following cyclosporine and diquafosol treatment in dry eye
Published in Annals of Medicine, 2023
Ha Rim So, Jiwon Baek, Ji Young Lee, Hyun Seung Kim, Man Soo Kim, Eun Chul Kim
Topical 0.05% cyclosporin A, 3.0% diquafosol tetrasodium, artificial tears are the most commonly used medications in dry eye treatment. The mechanism of action on dry eye is different among the three drugs. Cyclosporin A is known to reduce surface inflammation in dry eye by inhibiting T-cell activation and downregulating the production of inflammatory cytokines [16,17]. Conversely, diquafosol tetrasodium is a purinergic P2Y2 receptor agonist that stimulates water and mucin secretion from conjunctival epithelial cells and goblet cells [18,19]. Artificial tears are eyedrops used to lubricate dry eyes and help maintain moisture on the outer surface of eyes. The purpose of this study was to compare the expression of MMP-9 in dry eyes treated with either cyclosporin or diquafosol and their association with other dry eye markers.
A method for studying lipid adsorption to silicone hydrogel contact lenses
Published in Biofouling, 2021
In the current study, contact lenses were soaked in lipid solutions for 14 h to mimic the average one-day lens wear. It would be expected that if lenses were soaked in lipid solutions for different periods of time the concentration of lipids desorbed from lenses might vary and future studies should examine this effect. However, the levels of polar (PC) and non-polar (CE) lipids extracted from Lotrafilcon B and Senofilcon A were similar to a previous report, even though the length of the soaking time (14 h) and extraction time (5 min) in the current study differed from the earlier report (8 h and 25 s respectively) (Pucker et al. 2010b). In this study lenses were immersed in lipid solution in glass vials. This method has been used in many earlier studies to measure the deposition of tear compounds on contact lenses (Pucker et al. 2010b; Schuett and Millar 2017; Walther et al. 2018, 2021). A few recently published studies used a blink eye model, and a microfluidic pump to deliver artificial tears to the surface of contact lenses to mimic deposition of tear compounds on contact lenses in the eye (Phan et al. 2019, 2021). This model is not widely available in the market; nevertheless, it might demonstrate better results for measuring deposits on contact lenses. However, the effect of the eye model material, the tear flow rate, the distance between the eye lid and the surface of the eye model as well as the blink speed on contact lens deposits are yet to be identified.
Visual and Refractive Outcomes with a New Topography-integrated Wavefront-guided Lasik Procedure
Published in Current Eye Research, 2021
Antonio Uceda-Montañés, Michael Rogers, David P. Piñero
All TI-WFG LASIK surgeries were performed by the same experienced surgeon (AUM). The iFS femtosecond laser technology (Johnson & Johnson Vision, Jacksonville, FL) was used to generate the corneal flaps, with an intended flap thickness of 110 microns (µm) and a flap diameter between 8.5 and 9.3 mm. Once the flap was generated, it was carefully lifted and the laser ablation carried out using the variable spot scanning excimer laser STAR S4IR (Johnson & Johnson Vision, Jacksonville, FL). The ablation profile was calculated considering the data obtained with the iDesign 2.0 system. Treatments were programmed in all cases with a 6.0 to 6.7-mm optical zone and a total ablation zone of 8.0 mm, assuming a refractive target of emmetropia. Iris registration and eye tracking was used to ensure the centration of treatments during the ablation procedure. After ending the ablation, the stromal bed was irrigated with balanced saline solution, and the flap repositioned. As standard postoperative treatment, a combination of dexamethasone and tobramycin was prescribed to be applied five times a day for 1 week, tapering the frequency during the two more following weeks. Also, patients were prescribed to use artificial tears at least every 2 h the day after surgery and at least four times a day for 1 month.