Eye Lesions

The average time on practolol before symptoms appeared was about 25 months, with a range of 1-84 months (Nicholls 1978). 

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If HL (C03-A010) is involved, a BAL (British-anti-Lewisite, dimercaprol) solution or ophthalmic ointment may be beneficial if administered promptly. It may also decrease the severity of skin and eye lesions if applied topically within minutes after decontamination is complete (i.e., within 2-5 minutes postexposure). 

There is no antidote for exposure to these agents. Treatment consists of symptomatic management of lesions. Eye lesions should be treated by saline irrigation and coating the follicular margins with petroleum jelly to prevent sticking. 

Differential Diagnosis The clinical syndrome in an individual is not pathognomonic (distinctively characteristic of a particular disease or condition) but the occurrence of an epidemic with febrile disease, hemorrhagic fever, eye lesions, and encephalitus in different patients would be characteristics of Riff Valley fever. 

Practolol (Figure 8.13) was the prototype cardioselective p-adrenoceptor blocking agent. Selectivity was achieved by substitution in the para position with an acetyl anilino function. The similarity of this drug with those outlined above is obvious. Practolol caused severe skin and eye lesions in some patients which led to its withdrawal from the market [6]. These lesions manifested as a rash, hyperkeratosis, scarring, even perforation of the cornea and development of a fibrovascular mass in the conjunctiva, and sclerosing peritonitis. Some evidence is available that the drug is oxidatively metabolized to a reactive product that binds irreversibly to tissue pro-... 

Koshash I was going to ask a question about the food-anticipatory activity, but then I realized that the question was probably equally vahd for the eye lesion experiments that you mentioned at the end. Why is there a separate oscillator Is that a unique interpretation to those results ... 

Hughes33 cited these doses of H found by various experimenters to produce eye lesions ... 

In a second experiment, Ayers and Stahl studied the effects of discharging a CS pen-gun cartridge into a rabbit eye at a distance of 20 cm. At that distance, the wad caused less damage than the blast and the particles of CS. Only three of 10 animals suffered severe eye lesions, which appeared to combine mechanical damage (lacerations) from the wad and conjunctivitis, intraocular hemorrhage, keratitis, and corneal edema probably from the blast and CS particles driven into the eye. The other animals showed only mild conjunctivitis, which cleared after 3 d. 

In a chronic-duration study, groups of 60 male and 60 female Fiseher 344 rats were exposed to 0, 0.005, 0.025, or 0.164 ppm HDl over a 2-year period. Control rats were sham-exposed rats (conditioned air exposme). HDl caused eye irritation in males exposed to the 0.164 ppm dose only during the first year of the study but not dming the seeond year. No other HDl-related eye lesions were detected during ophthalmologic examinations performed dining the 2-year study (Mobay Corporation 1989). 

Some patients develop corneal opacities and other eye lesions several days after treatment. These are rarely severe and generally resolve without corticosteroid treatment. 

Nesswetha, W. 1969. Eye lesions caused by sulphur compounds, [in German]. Arbeitsmed. Sozialmed. Arbeitshyg. 4 288—290. 

Immediate eye pain and blepharospasm result from lewisite exposure, followed by conjunctival and lid edema. Severe exposures can produce necrotic injuries of the iris with depigmentation, hypopion, and synechia development. In contrast, very low levels may only involve the conjunctivae (McManus and Huebner, 2005). The eye lesions produced by lewisite are particularly serious blindness will follow contamination of the eye with liquid lewisite unless decontamination is prompt. 

SJS and TEN are systemic disorders typically presenting with constitutional signs, including fever, malaise, headache, loss of appetite, nausea, and vomiting.The skin is involved with inflammatory vesiculobullous lesions, frequently accompanied by hemorrhage and necrosis. In contrast, EMM usually presents with a diffuse erythematous papular and macular eruption that evolves into characteristic target or bull s-eye lesions with an erythematous center surroimded by a zone of normal skin and then by an erythematous ring. The soles of the feet and the palms of the hands often are affected in EMM. Mucous membranes of the nose and mouth are the most commonly affected, and conjunctival involvement is common in both EMM and SJS/TEN.At least two mucous membranes surfeces are involved in SJS and TEN. 

Mild eye lesions require little treatment other than flushing with water immediately. Slow running water is applied as one tilts the head from side to side, pulling the eyelids apart. Steroid and antibiotic ointment can be applied to the eye. 

British antilewisite (BAL) or dimercaprol was developed as an antidote for lewisite. It is used in medicine as a chelating agent for heavy metals. Although BAL can cause toxicity itself, evidence suggests that BAL in oil administered intramuscularly will reduce the systemic effects of lewisite. BAL skin and ophthalmic ointment decrease the severity of skin and eye lesions when applied immediately after early decontamination, but neither of these ointments is currently manufactured. 

Relapsing keratitis or keratopathy may develop years after apparent healing of severe eye lesions. Persistent eye conditions, loss of taste and smell, and chronic respiratory illness including asthmatic bronchitis, recurrent respiratory infections, and lung fibrosis may persist following exposure to sulfur mustards. Prolonged or repeated acute exposure to sulfur mustards may cause cutaneous sensitization and chronic respiratory disease. Repeated exposures result in cumulative effects because mustards are not naturally detoxified by the body. 

The eye is the organ most sensitive to mustard. The Ct required to produce an eye lesion under field conditions is 12-70 mg min/m (Papirmeister, 1991). The effective Ct for conjunctivitis, or slightly more severe damage, was just under 10 mg/m in 13 subjects several subjects had lesions at Cts of 4.8-5.S mg min/m (Reed, 1920). One subject had no symptoms after several hours however, by 12 h after the exposure, marked blepharospasm and irritation were apparent. 

An extremely painful eye lesion or an eye lesion that hinders vision... 

Dahl H, Gluud B, Vangsted P, Norn M. Eye lesions induced by mustard gas. Acta Ophthalmol Suppl. 1985 173 30-1)... 

Eye lesions most are resolved within 28 days of exposure. 

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