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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
A 65-year-old man developed a severe symmetrical blepharoconjunctivitis only 2 hours after instillations of four eye drops containing phenylephrine, tetracaine, fluorescein and tropicamide for a protocol study of fovea degeneration. These symptoms lasted 5 months in spite of using antiallergic ophthalmic topicals. The patient had received the same eye drops 3 years previously and had experienced ocular lacrimation with a conjunctival injection for 2 weeks. Skin prick-tests and intradermal tests with the eye drops containing 10% phenylephrine pure and diluted at 1:10 in water were negative at 20 minutes but positive at 8 hour, lasting for 7 days. Later, patch testing was positive for phenylephrine HCI 10% water (29). The same authors also reported the case of a 72-year-old-woman who presented an episode of blepharoconjunctivitis 10 hours after an intraocular examination using mydriatic eye drops containing phenylephrine. Patch testing was positive to the eye drops and negative to the excipients. There was no
Cranial Neuropathies I, V, and VII–XII
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Predictors of incomplete recovery are: Complete facial weakness.Pain other than in or around the ear (i.e. back of head, cheek, etc.).Older age.Hyperacusis.Decreased lacrimation.
Battlefield Chemical Inhalation Injury
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Specific chemical interactions with biological systems have been reported in limited fashion. Adamsite has been found to be an active inhibitor of chlorinesterase. This observation has led to speculation that the clinically observed lacrimation and rhinorrhea are due to this effect (Castro, 1968).
The Association Between Taxane Use and Lacrimal Disorders
Published in Current Eye Research, 2023
Gerald McGwin, Tucker Contorno, Matthew G. Vicinanzo, Cynthia Owsley
Reports of lacrimal disorders associated with docetaxel therapy began to appear in the literature soon after its approval in 1995.7 Since these early reports, studies have consistently reported the occurrence of excessive lacrimation with an incidence as high as >80%.4 The incidence does not appear to be associated with the underlying reason for use as it has been observed in patients receiving docetaxel for the treatment of breast, lung, ovarian cancer, among others. Additionally, a sensitivity analysis indicated that the associations were consistent when limited to indications for breast cancer, who may experience changes in estrogen activity which may lead to epiphora via effects directly on the ocular surface or on the meibomian glands, or via other mechanisms.9 This enhances the interpretation that the observed results are due to the medication, rather than indications for its use. Those patients receiving a frequent (e.g. once per week) or an extended treatment (e.g. six months) schedule appear to be at greatest risk of epiphora.4 While surgery is successful in resolving this condition, outcomes worsen with delays in seeking care, underscoring the importance of patient and provider education. For certain indications and patients (e.g. elderly), paclitaxel has been shown to have similar efficacy as docetaxel with less toxicity and better tolerability.10
Long-term Surgical Outcomes in Patients of Centurion Syndrome: A Mystic Etiology of Epiphora in Young
Published in Seminars in Ophthalmology, 2023
Manpreet Singh, Manpreet Kaur, Aditi Mehta, Manjula Sharma, Pankaj Gupta
The diagnosis was based on the clinical features of Centurion syndrome.2 The characteristic ophthalmic features included anterior displacement of MCT (Figure 1A,B), anterior dislocation of lacrimal punctum out of the tear lake or medial eyelid globe mal-apposition (Figure 2A–D), a prominent nasal bridge (Figure 1), beak sign (inferiorly angulated medial canthus- Figure 3A,B), a synophyrs (Figure 1), and enophthalmos.2,4 The patients having epiphora secondary to other issues of lacrimal drainage pathway and who underwent any surgery for epiphora treatment were excluded from our study. The ophthalmic conditions causing hyper-lacrimation like ocular surface dryness, eyelash, or eyelid margin anomalies (entropion or ectropion) were categorically ruled out. However, the patients with punctum ectropion (visible inferior punctum in primary gaze) were included and treated accordingly.
Olfactory Neuroblastoma: An Unusual Ocular Presentation
Published in Neuro-Ophthalmology, 2022
Dhabiah Saeed AlQahtani, Abdulaziz A. Alshamrani, Raniah AlQawahmed, Sahar Elkhamary, Huda AlGhadeer
Previous reports have indicated that they can present with unilateral vision loss, proptosis or proceeded by nasal symptoms such as epistaxis or discharge.2,4–6 Rakes et al. reported a large series of 38 cases, in which 53% presented with orbital or ocular symptoms. The most frequent symptoms were periorbital pain and lacrimation5. Moreover, diplopia was the first presenting ocular sign in 8% of the patients secondary to cranial nerve palsies.1 Lee and Tang also reported third cranial nerve palsy with pupil involvement due to mass extension to the cavernous sinus, without orbital involvement.7 Our patient presented with bilateral gradual vision loss without proptosis, ophthalmoplegia, proceeding nasal, sinuses, or neurological symptoms. The only evident finding was bilateral papilloedema secondary to raised intracranial pressure without optic nerve invasion along with central retinal vein occlusion in both eyes.