Treatment of Chronic Fatigue Syndrome
Jay A. Goldstein in Chronic Fatigue Syndromes, 2020
Numerous nerve branches in the vicinity of the temporomandibular joint distributed to the ear, temple, cheek, tongue, and teeth may be compressed in some patients with TMPDS and can simulate trigeminal neuralgia.133 Trigeminal nerve afferents project to the reticular formation and thalamus and thus may have widespread effects. Proparacaine 0.5% ophthalmic solution in the ipsilateral eye can produce rapid and long-lasting treatment of trigeminal neuralgial 34 and atypical facial pain. Proparacaine is of value in cluster and hemicranial migraine headache and sometimes fibromyalgia. Other ophthalmic agents may also ameliorate CFS by modulating trigeminal input to limbic structures. I am currently investigating ocular adrenergic and muscarinic agonists and antagonists, as well as prostaglandin synthesis inhibitors to treat CFS. (See Appendix.)
Novel Perspectives in Treatment of Fungal Keratitis
Mahendra Rai, Marcelo Luís Occhiutto in Mycotic Keratitis, 2019
Administration should be done in strict aseptic conditions preferably under operating microscope in an operation theatre. Topical anaesthesia is achieved by instilling 0.5% Proparacaine at 5-minute intervals 2–3 times. Anteriorchamber entry should preferably be done from infero-temporal site (being most accessible). In cases of overlying corneal opacity, AC entry should be made from other accessible sites. AC is entered with a 22–23G needle to facilitate extrusion of exudates/hypopyon from AC (Fig. 12.2). In cases of thick exudates, entry site can be enlarged by 11 No. blade to achieve AC wash and exudates can be aspirated by Simcoe cannula or removed with the help of McPhersons forceps. Due care should be taken to avoid inadvertent damage to corneal endothelium and lens. Aspirated exudates should be subjected to KOH wet mount smears. In addition, Gram and Giemsa stains should be prepared along with inoculation on culture media—Sabouraud’s Agar, Blood Agar, and Thioglycolate broth. After administration, wounds should be hydrated to achieve closure and if large, should be sutured with 10.0 monofilament nylon.
Ocular Irritation Testing
David W. Hobson in Dermal and Ocular Toxicology, 2020
Thus, it appears that most or all topical anesthetics are somewhat damaging to the cornea, and may, therefore, potentiate the irritancy produced by the test substance. It is difficult at this time to recommend that a topical anesthetic be used in conjunction with eye irritation tests because there are no data in the peer-reviewed literature which have evaluated the relative contribution of anesthesia to the irritancy of commercial or industrial products. However, the small amount of data which exist suggests that some topical anesthetics, particularly proparacaine, may have minimal or no adverse effects. The pursuit of research to determine the possible potentiative effects of this anesthetic on the ocular response to known irritants should be encouraged.
Ochrobactrum anthropi: A Rare Cause of Culture-Proven Acute Post-Operative Cluster Endophthalmitis
Published in Ocular Immunology and Inflammation, 2022
Naresh Babu Kannan, Piyush Kohli, Madhu Shekhar, Sagnik Sen, Prajna Lalitha, Aruna Pai, Kim Ramasamy
Lacrimal sac syringing is done a day before the planned surgery. The patient is placed in a supine position. Topical proparacaine drops (0.5%) are placed in the conjunctival sac to achieve adequate anesthesia. The lower punctum is dilated with the help of a punctum dilator. A 26-gauge blunt lacrimal cannula connected to a 5 mL syringe is inserted into the inferior canaliculus. The canaliculus is then irrigated with normal saline. The patients undergo surgery only if the nasolacrimal system is patented. The surgeries are performed under strict aseptic conditions. These include the sterilization of the periocular area using 10% Povidone-iodine (PI), the application of a sterile drape with an adhesive foil to keep the eyelashes away from the operative field, and the application of 5% topical PI drops in the conjunctival cul-de-sac. In addition, patients receive intracameral moxifloxacin (0.5 mg/0.1 ml) at the conclusion of the surgery as well as pre- and post-operative topical ofloxacin eye drops (0.3%).
Comparative Analysis of Matrix-Regenerating Agent and Corneal Cross-Linking in an Experimental Alkali Burn Rabbit Model
Published in Current Eye Research, 2022
Enes Kesim, Dilara Pirhan, Melda Yardimoglu Yilmaz, Nursen Yuksel, Yusufhan Yazir, Gozde Bicaklioglu, Selenay Furat Rencber
Based on sample size calculation using the G*Power software, 24 New Zealand female albino rabbits were used in this experimental study. The animals were randomly divided into three groups: 1) the control group was exposed to alkali burn and underwent no treatment, 2) the CXL group received 30 minutes of CXL at 24 hours after the injury, and 3) the RGTA group was treated with an RGTA at 24 hours after the injury. The study was conducted according to a protocol approved by the Kocaeli University Animal Experiments Local Ethics Committee (2/5-2017) and followed the Principles of Laboratory Animal Care guidelines. General anesthesia was administered using intraperitoneal injection of 1.1 ml ketamine hydrochloride (0.4 ml Xylazine HCl). Proparacaine hydrochloride was used for topical anesthesia. A filter paper of 8 mm diameter was used to absorb 1 M sodium hydroxide solution for 1 minute and placed onto the center of the right cornea for one minute. The eyes were washed immediately with 500 cc of 0.9% sodium chloride for two minutes.11 In all the animals, grade IV burns without limbal ischemia were confirmed according to the Roper Hall classification.12 The left eye was used as healthy control. The burn size was calculated as the average of the horizontal and vertical burn measurements. All animals received 0.1% dexamethasone phosphate four times per day for 10 days and moxifloxacin four times per day for 21 days. Two animals were excluded from the study due to burn sizes greater than 8 mm and two animals from the control group died due to general anesthesia complications.
The effect of intravitreal anti-vascular endothelial growth factor injections on corneal endothelium in patients with diabetic macular oedema
Published in Cutaneous and Ocular Toxicology, 2021
Irini Chatziralli, Panagiota Papadakou, Eleni Dimitriou, Dimitrios Kazantzis, Petros Kapsis, George Theodossiadis, Miltiadis Papathanassiou, Panagiotis Theodossiadis
All patients were treated with a loading dose of 5 consecutive monthly intravitreal anti-VEGF injections, either 0.5 mg/0.05 ml ranibizumab (Lucentis, Basel, Novartis) or 2 mg/0.05 ml aflibercept (Eylea, Regeneron, USA). Thereafter, all patients were followed-up at a pro re nata (PRN) basis, with regular monthly monitoring for 12 months after initial injection. At each visit, patients underwent BCVA measurement, slit-lamp examination, SD-OCT assessment, while corneal specular microscopy was performed at months 6 and 12 post initial injection. Re-injection was performed, if the height of macular oedema was ≥320 μm and if decrease in VA ≥1 Snellen line was noticed. All injections were performed under local anaesthesia (0.5% proparacaine) and under standard sterile conditions. The number of injections needed during the 12-month follow-up was recorded.
Related Knowledge Centers
- Conjunctiva
- Cornea
- Gonioscopy
- Receptor Antagonist
- Sodium Channel
- Topical Anesthetic
- Amino Esters
- Eye Drop
- Ocular Tonometry
- Corneal Opacity