The prompt effect of emedastine eye drop and the safety of its permanent use in children suffering from acute seasonal allergic conjunctivitis

INTRODUCTION: In the treatment of any disease, it is advantageous if the concentration of the administered drug is highest in the target organ. It follows that, if possible, diseases of the conjunctiva should primarily be treated with eye drops. AIMS: The author investigated the effect of an eye drop with selective H1-receptor antagonist properties, on children suffering from acute seasonal conjunctivitis. METHOD: During the first experiment 20 children (suffering from acute seasonal allergic conjunctivitis) had received Emadine eye drop (containing emedastine difumarate, an H1 antihistamine agent). The severity of the itching of the eye and the grade of hyperemia of the conjunctiva were scored on scales ranging 0 to 4 (score 4 representing the most severe symptoms). In the second experiment 232 other children had received this eye drop during two pollen seasons and the author investigated its effectiveness and side effects. RESULTS: The conjunctival itching decreased within less than 3 minutes significantly, and the redness was also reduced in an average of 8 minutes. In the second experiment none of the 232 children had to change this drug because of its ineffectiveness or side effects. CONCLUSIONS: Emadine eye drop decreases the itching and the redness of the conjunctiva very quickly and effectively. It is usable even for three-year-old patients, and it keeps its effectiveness during the long-term treatment, too.     

Eye complaints in the office environment: precorneal tear film integrity influenced by eye blinking efficiency

To achieve a common base for understanding work related eye complaints in the office environment, it is necessary to merge approaches from indoor air science, occupational health, and ophthalmology. Based on database searches, it is concluded that precorneal tear film (PTF) alteration leads to eye complaints that may be caused by: (1) thermal factors (low relative humidity; high room temperature); (2) demanding task content (attention decreases blinking and widens the exposed ocular surface area); and (3) individual characteristics (for example, tear film alterations, blinking anomalies, gland dysfunctions, and use of contact lenses). These factors and conditions are able to progressively increase water evaporation and faster thinning of the PTF, which causes dryness and dry spot formation on the cornea, possibly followed by corneal and conjunctiva epithelial alterations and eye complaints. Another possible cause of eye complaints is certain irritating chemical compounds, in addition to oxidation mixtures that are formed in reactions between ozone and unsaturated organic compounds (alkenes). The effect may be exacerbated by low relative humidity.     

Prevalence of objective eye manifestations in people working in office buildings with different prevalences of the sick building syndrome compared with the general population

Summary A cross-sectional clinical epidemiological study was carried out among 169 office workers in four Copenhagen town halls with different prevalences of the sick building syndrome. The results were compared with those in 112 subjects randomly selected from the general population. Biomicroscopic eye manifestations, such as premature break-up of the precorneal tear film, absence of foam at the inner eye canthus and epithelial damage of the bulbar conjunctiva, were investigated together with self-reported eye complaints. Although intercorrelated, the objective eye manifestations independently were statistically associated with self-reported eye complaints in office workers. The prevalence of the objective eye manifestations was significantly elevated in office workers compared with the general population and most pronounced for the buildings with a high prevalence of the sick building syndrome (P < 0.001). In the general population, subjects with a non-industrial occupation, including office workers, had a significantly higher prevalence of objective eye manifestations than those with an industrial occupation (P = 0.03), but the prevalence was still significantly lower than that among the office workers in buildings with a high prevalence of the sick building syndrome (P<0.001). Since possible confounders were found not to explain the difference in prevalence of objective eye manifestations and complaints among the two populations, it is concluded that the office environment (buildings and/or type of office work) promotes these objective changes accompanied by self-reported complaints.     

局部用药与激光联合治疗应用于中学生沙眼普治效果观察

目的　评价局部用药与激光联合治疗应用于中学生沙眼普治的效果,探讨沙眼治疗的有效方法。方法　将某校高一年级1~4班137名学生沙眼患者列为实验组, 5~8班132名学生沙眼患者作为对照组。实验组用1%丁卡因对患者上睑结膜、上穹窿部、下睑结膜、下窈窿部及眦部结膜行表面麻醉后,用激光烧灼滤泡及乳头,术后用四环素涂抹, 6h后,白天滴10%磺胺醋酰钠眼水,每日4次,夜间抹四环素眼膏。对照组仅给药物治疗。结果　实验组1个月治愈率74. 45%, 3个月治愈率98. 54%,复发率6. 6%。对照组1个月治愈率51. 52%, 3个月治愈率73. 48%,复发率43. 29%。激光治疗沙眼无明显不良反应,安全性好。结论　局部用药与激光联合治疗应用于中学生沙眼普治,较单纯局部用药效果好,复发率低,而且安全方便,值得推广。     

眼刺激试验对新化学物质危险性评价方法标准化的探讨

Three new chemicals, N-acyl glutamic acid as a stroma of cosmetics, an eye drops for myopia and 2, 4-dichloro-6-nitrophenylaminate (DCNP) as a new herbicide were evaluated with the eye irritation test. Japanese young rabbits were used, the right eye for test, the left as control. Before and after the test, the eye were stained with 2% sodium fluorescein and examined under slit-lamp microscope to observe the damage degree of cornea, and to record the reaction degree of conjunctiva and iris at the same time. Using the draize method to compare with three kinds of granding (method of bayard and hehir, of EPA and of NRC), the results were essentially the same. The severity of reaction to the eye irritation test is closely related to the kind of testing material and the concentration used and the length of time exposed. The standardization of eye irritation test is also discussed.     

儿童不典型川崎病的临床分析

[目的]分析儿童不典型川崎病的临床特点,为能尽早明确诊断提供依据。[方法]对2006年6月~2010年6月在我院诊断的49例不典型川崎病患儿的临床表现及实验室检查指标进行回顾分析,并与同期的143例典型川崎病进行比较。[结果]49例不典型川崎病均有发热,其中持续5d以上发热者47例(95.9%)。除发热外其他临床表现以眼结膜充血和口唇黏膜改变发生率最高,分别为89.8%和81.6%。实验指标中以血沉增快、外周血白细胞升高、CRP增高的发生率较高,分别为89.9%、85.7%、81.1%,常伴有血红蛋白和血浆白蛋白降低,与典型川崎病具有一致性。[结论]不典型川崎病早期表现隐匿,临床医师应具有对本病的警惕性,进行周密的临床观察,结合实验室检查综合分析,以求早诊断、早治疗,减少冠状动脉的损伤。对不明原因的发热,实验检查血沉增快,CRP增高,外周血白细胞升高,血红蛋白降低,血浆白蛋白降低,血钾、血钠水平降低可作为诊断不典型川崎病的参考指标。     

Effects of emedastine eyedrops on acute seasonal allergic conjunctivitis in children

The developments of the symptoms of acute allergic inflammation of the conjunctiva (itching of the eye, conjunctival hyperaemia and oedema, and lacrimation) is largely due to the histamine released in the course of the allergic reaction. A major role in its treatment is therefore played by eyedrops with an antihistamine effect. The aims of the present study were to establish whether there is a rapid effect of eyedrops containing the selective H1 receptor blocker emedastine on acute seasonal allergic conjunctivitis and, if so, the time required for this effect to develop. Eyedrops containing emedastine were administered in the ragweed season to 20 children (12 boys and 8 girls) with acute allergic inflammation of the conjunctiva resulting from a hypersensitivity to ragweed pollen, the average age of the 20 children was 12.3 years (range: 5-19). The degrees of itching of the eye and of conjunctival hyperaemia were each characterised on a scale ranging from 0 to 4 (4 denoting the most severe symptoms). It was found that, after a single administration of 1 emedastine eyedrop, the degree of itching of the eye fell from the starting score of 2.85 +/- 0.75 to 0.45 +/- 0.51 within an average of 2.95 minutes, while the conjunctival hyperaemia fell from 2.35 +/- 0.59 to 0.55 +/- 0.51 in an average of 7.7 minutes. The level of the improvement for both symptoms was highly significant. An undesirable side effect (a burning sensation on the eyeball) was observed in one case. It may be stated that the eyedrop containing emedastine effectively decreases the extents of itching of the eye and conjunctival hyperaemia in children with acute allergic conjunctivitis, its effects are exerted within minutes.     

Nosocomial Pseudomonas aeruginosa conjunctivitis in a pediatric hospital

Conjunctivitis accounted for 5% of nosocomial infections occurring in a university-affiliated pediatric hospital between January 1984 and April 1986. Pseudomonas aeruginosa was recovered from the conjunctiva of 30 patients. The primary diseases of these patients were chronic and debilitating. Eighty percent of patients were under 18 months of age although only 30% of admissions are represented in this age group. Seventy percent of cases occurred in pediatric intensive care unit/neonatal intensive care unit patients. Seventy percent of patients who had antecedent nasopharyngeal/endotracheal cultures obtained were colonized with P aeruginosa. All patients except one had one or more of the following interventions prior to the onset of conjunctivitis: tracheostomy, endotracheal tube, oxygen by hood, or suctioning. Two children (7.4%) have residual corneal scars. Improvements in eye care including protection of the eye during suctioning, other respiratory care, and nasogastric tube procedures are warranted.     

放射根瘤菌致白内障术后急性眼内炎首例报告

了解放射根瘤菌致白内障术后急性眼内炎的临床特点及治疗转归。回顾性收集1例白内障患者手术后放射根瘤菌急性眼内炎的临床资料, 结合国内外相关文献进行分析。患者右眼白内障手术后4 d, 出院后因"右眼急性化脓性眼内炎"收住入院。入院当天即行右眼玻璃体切割联合人工晶体取出、后囊膜切开等手术, 术中取玻璃体液培养, 结果为放射根瘤菌, 可能是接触蔬菜根上的土壤后触摸眼结膜引发感染。采用敏感抗菌药物头孢他啶(全身用药)和左氧氟沙星(局部滴眼)治疗, 术后21 d眼部症状稳定, 矫正视力为20/133, 眼部感染治愈出院。此病例为国内首例白内障手术后放射根瘤菌急性眼内炎, 临床应重视由该菌引起的眼部感染, 白内障手术后或玻璃体内注射药物后应避免接触土壤, 出现症状需及时送细菌培养, 并根据药敏结果进行精准治疗。     

Past and current medical states of yusho patients

A subacute poisoning, "yusho," caused by the ingestion of Kanemi rice oil which had been accidentally contaminated with polychlorinated biphenyls (PCBs), occurred in the western part of Japan in 1968. During the past decade, various clinical symptoms of yusho patients have diminished gradually. However, some of the symptoms and signs, such as pigmentation of the skin, conjunctiva and gingiva, eye discharge, and various nonspecific general symptoms still remain in a number of severely ill patients. In this report, clinical observations of yusho patients during 1968-78 are briefly reviewed.     

Bias due to conjunctiva hue and the clinical assessment of anemia

The influence of conjunctiva hue on the clinical evaluation of anemia was tested by three educated non-clinicians, trained for such a purpose, in 219 healthy ambulatory subjects. Over 27% of conjunctivae were classified as pink and 72.8% as reddish; the three observers agreed on 8.2% of the pink and on 49.8% of the reddish. Anemia (hemoglobin below 10.0 g/dl) was detected in 5.4% of the subjects with pink hue, and in 3.4% of subjects with reddish hue. Between 39.7 and 62.2% of the subjects with pink conjunctiva were misclassified as anemic by at least one worker, and between 20.0 and 50.0% of those with reddish conjunctiva were misclassified as not anemic. Overall agreement on conjunctiva hue for the 219 worker pairs ranged from 69.0 to 75.0%; the three kappa coefficients were between 0.27 and 0.34. The importance of conjunctiva hue variation will depend on the objective of the assessment and on the availability of laboratory tests. Bias due to conjunctiva hue should be stressed when clinicians and field personnel are under training.     

Changes in the anterior segment of the eye in workers in the coke manufacturing industry

An investigation carried out of eye disorders in workers employed in the manufacture of coke demonstrated a high percentage of changes in the anterior segment of the eye. Registered symptoms such as conjunctival hyperemia, pinguecula, pigmentation and conjunctivitis were most probably connected with specific work and exposure to coal dust and irritants. In workers exposed for less than two years there were no changes in lacrimal secretion. In those working for 2-7 years excessive hypersecretion dominated, and after a longer period of exposure the majority of workers had hyposecretion.     

Chlamydia trachomatis in the conjunctiva of children living in three rural areas in Mexico.

OBJECTIVES: Chlamydia trachomatis infections, in the context of extreme poverty, may trigger trachoma. Because the levels of C. trachomatis eye infections in Mexico are unknown, this study sought to determine if C. trachomatis was present in the conjunctiva of children living in three poor, rural areas of the country. METHODS: Clinical diagnosis of conjunctival follicles in children was conducted during the 2004 visual acuity assessment campaigns in rural areas of the states of Chiapas, Oaxaca, and Zacatecas. C. trachomatis detection was carried out by sampling the children with follicles and examining the specimens after Giemsa or microimmunofluorescence (MIF) staining. RESULTS: A total of 941 children from 6 to 12 years of age were examined in 2004. Of the 484 in Chiapas, 30% were found to have follicles; of the 181 in Zacatecas, 22%; and of the 276 in Oaxaca, 42%. C. trachomatis was detected at levels ranging between 2% and 5%; positive by Giemsa in 4.5% of the children with follicles, and by MIF in 15.5%. CONCLUSIONS: Considering that the chlamydiae sampling procedures and detection methods used in this study were not the most sensitive, the results underestimate the chlamydial eye infections and represent a conservative assessment of a potential risk for preventable visual impairment. Because C. trachomatis was detected here at levels similar to those reported for low-endemic trachoma areas, health authorities should be prepared to implement appropriate measures should it be confirmed that the visual health of Mexico's children is at risk.     

Eye irritation and environmental factors in the office environment--hypotheses, causes and a physiological model

The study reviews eye irritation using a multidisciplinary approach. Potential risk factors and objective gender differences are identified, and possible hypotheses for eye irritation caused by indoor air pollution are discussed. Eye irritation depends somewhat on destabilization of the outer-eye tear film. An integrated physiological risk model with blink frequency, destabilization, and break-up of the eye tear film as inseparable phenomena may explain eye irritation among office workers in terms of occupational, climate, and eye-related physiological risk factors. Certain volatile organic compounds that are both chemically reactive and airway irritants may cause eye irritation. If airborne particles alone should destabilize the tear film and cause eye irritation, their content of surface-active compounds must be high. Personal factors (eg, use of contact lenses, eye make-up, and certain medication) may also affect destabilization of the tear film and possibly result in more eye symptoms.     

Assessment of changes in eye redness by a photographic method and the relation to sensory eye irritation

The purpose of the present study was to evaluate the relation between photographically assessed changes in eye redness and sensory eye irritation in 17 patients suffering from hayfever, provoked by increasing doses of birch pollen in the eye. Pre- and post-exposure diapositives were compared in a randomized and double blind design by a panel of five members. By evaluating the photographs we found a high reproducibility between panel members and for repeated evaluation by the individual panel member. Furthermore, we found that the photographic method was more sensitive for measurements of changes in eye redness than the observations normally performed during such conjunctival provocation tests. The correlations of the objective findings with the symptoms reported were good at high pollen doses, but at lower doses of birch pollen (about half the effective dose) a decreased eye redness was observed. We found that sensory irritation (often expressed as dryness) measured simultaneously by questionnaires, in general occurred before any increased eye redness. The study indicates that photographic measurement of eye redness is reproducible, sensitive, unbiased and therefore a useful tool in environmental studies. Furthermore we demonstrated that the relation between eye redness and eye irritation is interestingly biphasic and may need further clarification.     

The Protective Effect of Oral Application of Corni Fructus on the Disorders of the Cornea,Conjunctiva, Lacrimal Gland and Retina by Topical Particulate Matter 2.5

Particulate matter 2.5 (PM_2.5) may aggravate dry eye disease (DED). Corni Fructus (CF), which is fruit of Cornus officinalis Sieb. et Zucc., has been reported to have various beneficial pharmacological effects, whereas the effect of CF on the eye is still unknown. Therefore, in this study, we investigated the effect of oral administration of water extract of CF (CFW) on the eye, hematology, and biochemistry in a DED model induced by topical exposure to PM_2.5. Furthermore, the efficacy of CFW compared with cyclosporine (CsA), an anti-inflammatory agent, and lutein, the posterior eye-protective agent. Sprague-Dawley rats were topically administered 5 mg/mL PM_2.5 in both eyes four times daily for 14 days. During the same period, CFW (200 mg/kg and 400 mg/kg) and lutein (4.1 mg/kg) were orally administered once a day. All eyes of rats in the 0.05% cyclosporine A (CsA)-treated group were topically exposed to 20 μL of CsA, twice daily for 14 days. Oral administration of CFW attenuated the PM_2.5-induced reduction of tear secretion and corneal epithelial damage. In addition, CFW protected against goblet cell loss in conjunctiva and overexpression of inflammatory factors in the lacrimal gland following topical exposure to PM_2.5. Furthermore, CFW markedly prevented PM_2.5-induced ganglion cell loss and recovered the thickness of inner plexiform layer. Meanwhile, CFW treatment decreased the levels of total cholesterol and low-density lipoprotein cholesterol in serum induced by PM_2.5. Importantly, the efficacy of CFW was superior or similar to that of CsA and lutein. Taken together, oral administration of CFW may have protective effects against PM_2.5-induced DED symptoms via stabilization of the tear film and suppression of inflammation. Furthermore, CFW may in part contribute to improving retinal function and lipid metabolism disorder.     

Detection of human papillomavirus in squamous cell carcinoma of conjunctiva by nested PCR: a case control study in Iran

Squamous-cell carcinoma (SCC) of the eye conjunctiva is a rare tumor. Its link with immune impairment suggests that infectious agents such as human papillomavirus (HPV) may be involved in the etiology of SCC. We conducted a case-control study on 50 SCC cases (mean age: 65.2) and 50 age frequency-matched control patients with lesion-free, normal conjunctival biopsies (mean age: 63.8) obtained from the cancer registry archive at Pathology Department of Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran, where SCC has become the most common conjunctival malignancy. MY/GP nested PCR was performed for HPV detection and E6/E7 consensus primers in combination of type specific primers were used in another nested PCR series for HPV typing. HPV DNA was detected in 46 of 50 samples of squamous cell carcinoma and none of the normal biopsies by nested PCR using primer sets of the HPV consensus L1 region (MY/GP). Subsequently, specimens from the 46 positive cases were subjected to specific PCR. Although 630bp amplicon was produced in 44 of 46 samples (E6/E7 primers), none of the specific HPV PCR reactions for HPV DNA type 16, 18, 31 or 33 resulted in the detection of HPV DNA in the 44 SCC specimens of the conjunctiva. Current results confirm the role of HPV in the etiology of conjunctival SCC. The absence of HPV 16, 18, 31 and 33 in conjunctival SCC in this study raise doubts about the role of genital types of HPV in conjunctival carcinomas.     

致渔民眼部灼伤的船舱内硫化氢污染调查

目的 调查渔民发生眼部灼伤的船舱中硫化氢(H2S)的污染情况.方法 共监测56艘渔船舱内H2S浓度,56名渔民接受眼部检查.其中,对21艘既发生渔民眼灼伤又符合监测条件的渔船进行舱内空气采样,以确定H2S灼伤眼部及全身中毒的末期浓度;并对舱内H2S浓度、舱内作业时间与眼灼伤程度之间关系进行分析;将30艘未卸鱼货渔船分为2组,分别应用鼓风、喷洒法和自然敞开法消散H2S,以确定消散H2S的有效方法.选定只有眼部球结膜轻度充血或轻微咳嗽的渔民所在5艘渔船进行单次监测,确定H2S灼伤眼、呼吸道黏膜的阈浓度.结果 56名接受眼部检查的渔民中,有46例(92只眼)发生眼灼伤,其中中度灼伤10例(20只眼)、轻度36例(72只眼),来自21艘船.21艘引起渔民眼灼伤渔船舱内H2S浓度为(99±38)mg/m3.30艘未卸货渔船舱内首次监测H2S浓度为(219±31)mg/m3;鼓喷组H2S浓度为(213±24)mg/m3,自然敞开组H2S浓度为(225±36)mg/m3;消散1.0 h后鼓喷组H2S浓度为(21±3)mg/m3,衰减(192±21)mg/m3,衰减率为90%;自然敞开组H2S浓度为(184±36)mg/m3,衰减(41±8)mg/m3,衰减率为18%;两组衰减浓度比较差异有统计学意义(t=25.627,P＜0.05).渔船舱内引起渔民眼灼伤的阈浓度为38 mg/m3.暴露时间120 min,10例眼部中度灼伤渔民所在7艘渔船舱内H2S浓度为(123±9)mg/m3;19例轻度眼灼伤渔民所在7艘渔船舱内H2S浓度为(54±7)mg/m3,两组H2S浓度比较,差异有统计学意义(t=14.236,P＜0.05).结论 船舱内H2S浓度高,暴露时间长,可加重渔民眼部灼伤.短时间消散船舱内H2S有效方法为舱底鼓风、舱内喷洒雨雾.     

Strategies to improve the reporting of legal blindness in Massachusetts.

OBJECTIVES: Registration practices were evaluated as the initial phase of a validation study of the Register of the Massachusetts Commission for the Blind. METHODS: Massachusetts eye care providers were surveyed to determine factors associated with nonreporting of legal blindness to the commission. RESULTS: Among ophthalmologists, factors associated with nonreporting were small practice size and practicing for 5 years or less in Massachusetts. Among optometrists, factors included small practice size and unawareness of the Massachusetts reporting law. CONCLUSIONS: Information should be disseminated to eye care providers, legally blind patients, and the public to ensure registration and sustain it.     

高传能线密度辐射对人眼晶状体的危害

眼晶状体是人体对辐射最敏感的组织之一,电离辐射的生物效应因其传能线密度(linear energy transfer,LET)的不同而不同,同等吸收剂量条件下,高LET辐射生物效应比低LET辐射更强,尽管目前辐射对眼晶状体的影响这一领域已经有了较多研究,但对于高LET对眼晶状体的影响知之甚少.本文简述人眼晶状体剂量限值...