Ocular complications of herpes zoster ophthalmicus

Fifty percent of patients with ophthalmic zoster develop ocular complications. These may be mild or severe, and can lead to loss of sight which, by timely and good management can be prevented in most cases. Unfortunately knowledge of the complications and their management is often poor making the design and interpretation of clinical trials difficult. 1356 cases of ophthalmic zoster were collected over fifteen years with at least 6 months follow up. Their details and complications were entered into a database. There is a generally held impression that patients developing zoster do so because of impaired immunity. Analysis of our findings showed that this was not so. The database results were analyzed to quantify the incidence of complications and their correlates. Two common corneal complications that are difficult to manage and lead to visual impairment were studied in detail including: Mucous plaque keratitis is defined as a distinct entity appearing at an early or late stage and occurred in forty seven cases. Poor management leads to visual impairment from neurotrophic ulceration, megaplaque keratitis and glaucoma. Lipid keratopathy induces diminished visual acuity and photophobia. It occurred in thirty six cases. Careful and prolonged treatment of chronic stromal keratitis with topical steroid will prevent this occurring, but when it does successful laser occlusion of corneal blood vessels halts the deposition of lipid and may actually disperse it or make the host cornea safer for keratoplasty. One hundred and seventy six patients were screened orthoptically and the incidence of extraocular muscle palsies assessed with regard to distribution and natural history. Possible pathogeneses are discussed. Overall recovery was good. Lastly iritis and iris atrophy were identified in five hundred and twenty patients and twenty three were investigated with anterior segment fluorescein angiography. This showed that they were associated with an ischaemic vasculitis

Toxoplasmosis gondii: An Atypical Presentation of Optic Neuritis

Toxoplasmosis gondii is a parasite whose natural host is the cat. Ocular toxoplasmosis can be categorized into two forms of infections: congenital, where an infant is infected in utero; and acquired, where an individual is typically infected by ingesting food contaminated with T. Gondii oocytes. Although acquired infections are rare in the United States, they can occur and toxoplasmosis should be in the differential diagnosis of an infectious optic neuritis. The typical manifestation of toxoplasmosis is a retinochoroiditis, with a “headlight in the fog” appearance, due to dense inflammation of the vitreous; consequently, the diagnosis is often made clinically. This case describes a healthy 36-year-old Hispanic male who had an atypical presentation, with minimal vitritis and papillomacular involvement; thus serology was necessary for a definitive diagnosis. Treatment led to a rapid improvement in vision and ultimately a good prognosis

Practical Ophthalmology

The study guide is intended to train students of higher medical educational institutions of the fourth level of accreditation on the specialty “Medicine”, interns, residents and masters. The guide is a new progressive step in teaching the discipline “Ophthalmology”

Penetration enhancers in ocular drug delivery

There are more than 100 recognized disorders of the eye. This makes the development of advanced ocular formulations an important topic in pharmaceutical science. One of the ways to improve drug delivery to the eye is the use of penetration enhancers. These are defined as compounds capable of enhancing drug permeability across ocular membranes. This review paper provides an overview of anatomical and physiological features of the eye and discusses some common ophthalmological conditions and permeability of ocular membranes. The review also presents the analysis of literature on the use of penetration-enhancing compounds (cyclodextrins, chelating agents, crown ethers, bile acids and bile salts, cell-penetrating peptides, and other amphiphilic compounds) in ocular drug delivery, describing their properties and modes of action

Skin Diseases and Sexually Transmitted Infections

ПОСОБИЯКОЖНЫЕ БОЛЕЗНИДЕРМАТОЛОГИЯВЕНЕРОЛОГИЯИНОСТРАННЫЕ СТУДЕНТЫВЕНЕРИЧЕСКИЕ БОЛЕЗНИПособие охватывает как общие, так и редкие вопросы дерматологии и венерологии. Содержатся главы о кожных и венерических заболеваниях, которые являются общими для Азии, Африки и Латинской Америки

Advances in Ophthalmology

This book focuses on the different aspects of ophthalmology - the medical science of diagnosis and treatment of eye disorders. Ophthalmology is divided into various clinical subspecialties, such as cornea, cataract, glaucoma, uveitis, retina, neuro-ophthalmology, pediatric ophthalmology, oncology, pathology, and oculoplastics. This book incorporates new developments as well as future perspectives in ophthalmology and is a balanced product between covering a wide range of diseases and expedited publication. It is intended to be the appetizer for other books to follow. Ophthalmologists, researchers, specialists, trainees, and general practitioners with an interest in ophthalmology will find this book interesting and useful

Perspectives on the incidence of Acanthamoeba Keratitis: A Systematic Review and Meta-Analysis

TOPIC: To provide an overview on the incidence of Acanthamoeba Keratitis (AK). CLINICAL RELEVANCE: Although being a major and sight-threatening cause of infectious keratitis in the population, a comprehensive assessment of the incidence of this condition is lacking. METHODS: Incidence of AK was computed as the number of AK eyes, per healthcare center, per year (annualized-center-incidence, or ACI). Two meta-analytical ratios were also calculated: a) the ratio of AK eyes to the count of non-viral microbial keratitis (MK) eyes; b) the ratio of AK eyes to the overall population (i.e., the total number of subjects of a nation or region, as indicated by the authors in each study). Center was defined as the healthcare facility (e.g., Hospital, Private Practice, Clinic) where the study took place. Actual and projected estimates of the number of AK eyes in years were calculated multiplying the ratio of AK to the total population and the corresponding present and projected population estimates (age range: 15 to 70), sourced from the United Nations (UN) Population Prospects. RESULTS: Overall, 105 articles were included, published between 1987 and 2022. The total number of eyes identified was 91,951, with 5,660 affected by AK and 86,291 by non-viral MK. The median ACI was 1.9 new AK eyes per healthcare center per year (95%CI of the median: 1.5 to 2.6), with no statistically significant differences observed among continents. The ratio of AK eyes to the total number of MK eyes was 1.52% (95%CI: 1.02% to 2.24%), while the ratio of AK in relation to the entire population was estimated at 0.0002% (95%CI: 0.0001 to 0.0006), or 2.34 eyes per 1,000,000 subjects (95%CI: 0.98 to 5.55 per 1.000.000 subjects). The projected increase in the numbers of AK eyes indicates a rise of +18.5% (15,356 AK eyes) in 2053 and +25.5% (16,253 AK eyes) in 2073, compared to the baseline of 2023 (12,954 AK eyes) CONCLUSION: AK emerged as a relatively low-incident disorder, and no significant differences in terms of its incidence were found among different continents